Indian Public Health Standards

INDIAN PUBLIC HEALTH
STANDARDS
Health and wellness centRE-
Sub health centre
2022
Volume-IV
Ministry of Health & Family Welfare
Table of Contents
List of Abbreviations xix

Reader’s Guide for Health & Wellness Centre - Sub Health Centre xxiii
1. Background 1
2. Introduction 4
3. Objectives of IPHS for HWC-SHC and UHWC 6
4. Types/Categories of HWCs 7
5. Population Norms for HWC-SHC and UHWC 8
6. General Principles 9
7. Criteria for IPHS Compliance 11
8. Service Provision 12
8.1. Infrastructure 13
8.1.1. General Appearance and Upkeep 15
8.2. Human Resources for Health 22
8.2.1. Capacity Building 23
8.2.2. Conduct and Behavioural Standards 23
8.2.3. Safety Measures for HRH 24
8.3. Medicines 24
8.4. Diagnostics 25
8.5. Equipment 25
8.6. Quality Assurance 26
8.7. Implementation of IPHS 28
8.7.1. Governance 28
8.7.2. Monitoring 29
8.7.3. Jan Arogya Samiti 29
8.7.4. Accountability 30
8.7.5. Patient Centric Services 30
8.7.6. Grievance Redressal 30
8.7.7. Information and Communication Technology 30
8.7.8. Intersectoral Convergence 31
Table of Contents | xvii

Annexures
Annexure 1 35
Citizens’ Charter
Annexure 2 36
Service Delivery Framework
Annexure 3 48
Layout plan of HWC-SHC without Labour Room and with Residential Facility 48
Layout plan of HWC-SHC without Labour Room and without Residential Facility 50
Layout plan of HWC-SHC with Labour Room and without Residential Facility 51
Layout plan of HWC-SHC with Labour Room and with Residential Facility 52
Layout plan of HWC-SHC New Construction 54
Annexure 4 57
Disaster Management & Preparedness
Annexure 5 60
Roles & Responsibilities of HWC-SHC Staff
Annexure 6 68
List of Essential Medicines for HWC-SHC/UHWC
Annexure 7 72
List of Diagnostics Tests & Equipment for Gap Analysis at HWC-SHC and UHWC
Annexure 8 73
List of Equipment and Consumables for HWC-SHC/UHWC
Annexure 9 75
Cleaning Protocols at HWC-SHC/UHWC
Annexure 10 78
Service Area Wise Protocol
Annexure 11 80
Checklist for Daily Rounds
Annexure 12 82
List of Contributors
xviii | INDIAN PUBLIC HEALTH STANDARDS | Health and Wellness Centre - Sub Health Centre
List of Abbreviations
AEFI Adverse Events Following Immunization

AFB Acid-Fast Bacillus
AFHC Adolescent Friendly Health Clinics
AIDS Acquired Immuno Deficiency Syndrome
ANC Ante Natal Care
ANM Auxiliary Nurse Midwife
ARI Acute Respiratory Infection
ASHA Accredited Social Health Activist
AYUSH Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homeopathy
BCC Behavioural Change Communication
BMWM Bio Medical Waste Management
CDR Child Death Review
CHC Community Health Centre
CHO Community Health Officer
COPD Chronic Obstructive Pulmonary Disease
CPHC Comprehensive Primary Health Care
DH District Hospitals
DOTS Directly Observed Treatment, Short-Course
EDL Essential Drugs List
EML Essential Medicines List
ENT Ear, Nose, and Throat
ETP Effluent Treatment Plan
FRU First Referral Units
FSSAI Food Safety and Standards Authority of India
GBV Gender Based Violence
GOI Government of India
HCG Human Chorionic Gonadotropin
HD High Definition
HIV Human Immunodeficiency Virus
HRH Human Resource for Health
HRMIS Human Resource Management Information System
HWC Health and Wellness Centre
ICDS Integrated Child Development Services
ICT Information and Communication Technology
ICTC Integrated Counselling and Testing Centre
List of Abbreviations | xix

IEC Information, Education and Communication
IFA Iron Folic Acid
IPHS Indian Public Health Standards
IT Information Technology
IUCD Intra Uterine Contraceptive Device
JAS Jan Arogya Samiti
LCD Liquid Crystal Display
LED Light Emitting Diode
MAS Mahila Arogya Samiti
MBPS Mega Bits per Second
MCP Mother and Child Protection
MDSR Maternal Death Surveillance and Response
MDT Multi Drug Therapy
MGNREGA Mahatma Gandhi National Rural Employment Guarantee Act
MO Medical Officer
MPW Multi Purpose Worker
MTP Medical Termination of Pregnancy
MVA Manual Vacuum Aspiration
NBC National Building Code
NCD Non-Communicable Disease
NHP National Health Policy
NIN National Identification Number
NQAP National Quality Assurance Program
NQAS National Quality Assurance Standards
NRC Nutrition Rehabilitation Centre
NRHM National Rural Health Mission
NUHM National Urban Health Mission
NRLM National Rural Livelihood Mission
OOPE Out of Pocket Expenditure
OPD Out-Patient Department
ORS Oral Rehydration Solution
OT Operation Theatre
pH Power of Hydrogen
PHC Primary Health Centre
PHM Public Health Manager
PLHA Person living with HIV and AIDS
PMJAY Pradhan Mantri Jan Arogya Yojana
PNC Post Natal Care
PPTCT Prevention of Parent To Child Transmission
PPE Personal Protective Equipment
PPH Postpartum Haemorrhage
PRI Panchayat Raj Institution
RBSK Rashtriya Bal Swasthya Karyakram
RCH Reproductive and Child Health
xx | INDIAN PUBLIC HEALTH STANDARDS | Health and Wellness Centre - Sub Health Centre
RLB Rural Local Bodies
RTI Respiratory Tract Infections
RWA Resident Welfare Association
SAM Severe Acute Malnutrition
SDG Sustainable Development Goal
SDH Sub District Hospitals
SHC Sub Health Centre
SHG Self Help Group
STI Sexually Transmitted Infections
TB Tuberculosis
TOR Terms of Reference
UCHC Urban Community Health Centre
UHC Universal Health Coverage
UHND Urban Health and Nutrition Day
UHWC Urban Health and Wellness Centre
ULB Urban Local Bodies
UPHC Urban Primary Health Centre
URI Upper Respiratory Infection
VDRL Venereal Disease Research Laboratory Test
VHND Village Health and Nutrition Day
VHSNC Village Health Sanitation and Nutrition Committee
WCD Women and Child Development
WIFS Weekly Iron and Folic Acid Supplementation
List of Abbreviations | xxi

Reader’s Guide for Health &
Wellness Centre - Sub Health
Centre
There is no right or wrong way to use the Indian Public Health Standards (IPHS) 2022. You can go to the section
you are interested in and get the information straight away on. It could be related to infrastructure, human
resources for health (HRH), drugs, diagnostics, or you can read through the entire book to understand what
the expected standards are at a particular level of facility. We expect that the public health planners would
use this book as a reference and return to it time and again.
Each book has sections dedicated to the objectives of IPHS, its guiding principles, population norms, the
essential and desirable standards (desirable services/HR/ diagnostic tests and equipment are over and
above indications mentioned as essential) for service provision, as well as a framework for implementation
of IPHS.
yy Section 1: The Background section provides a summary of the importance of strengthening of
primary health care services in India and the basis for the establishment of health and wellness
centres. It also includes the importance of having the Indian Public Health Standards (IPHS).
yy Section 2: The section on Introduction includes the rationality behind revising the IPHS. It briefly
describes how IPHS can accelerate India’s progress towards achievement of UHC and Sustainable
Development Goal - 3 (SDG 3) in alignment with the National Health Policy 2017.
yy Section 3: This enlists the key Objectives of the Indian Public Health Standards (IPHS) for Sub
Health Centres- Health and Wellness Centres and Urban Health & Wellness Centres.
yy Section 4: It includes the Types or categories of HWCs, the purpose of establishing them and the
population norms at which the HWCs are to be established in the rural as well as the urban areas.
yy Section 5: It includes the population norms for all types of HWC-SHC and UHWCs.
yy Section 6: It contains the General Principles to be adopted by the States and Union Territories
to strengthen the service delivery and ensure better implementation of the National Health
Programmes.
yy Section 7: Defines the minimum Criteria for the health care and facility to be identified as ‘IPHS
Compliant’.
yy Section 8: The section on Service Provision includes the details of:
a. The basis for establishing the health facilities, infrastructure requirement and the general
appearance and upkeep of the facilities;
b. Prescribed norms to be followed for illumination, fire safety, disaster and emergency
preparedness, water and sanitation and power backup;
c. Standard protocol to be adopted for better service delivery;
d. HRH requirement for ensuring service availability, conduct and behavior standards and safety
measures to be adopted for the HRH;
Reader’s Guide for Health & Wellness Centre - Sub Health Centre | xxiii
e. Essential medicines to be available free of cost in the health facilities under ‘Free Drug Service
Initiative’ of GoI;
f. Essential diagnostics to be provided in the health facilities;
g. Equipment required for providing the services being offered through the facilities;
h. Quality Assurance Protocol to be adopted including a road map for healthcare facilities to
achieve NQAS certification;
i. Ensuring accountability and governance in service delivery; and
j. Framework of implementation of IPHS.
xxiv | INDIAN PUBLIC HEALTH STANDARDS | Health and Wellness Centre - Sub Health Centre
Background 1
Section
India has a rich past in the field of medical sciences. Both physical and mental health were considered
important parameters of health. The ‘Charaka Samhita” was the mainstay for medicine for centuries and
“Sushruta Samhita” was the ancient medical compendium of surgery compiled around 6th century B.C.
The Buddhist era in the 6th century B.C. saw the establishment of “Viharas” - monasteries for the care of the
sick, impoverished, and disabled, as well as medical education. Several hospitals were operational throughout
King Ashoka’s reign in the 2nd century B.C. Modern hospitals and healthcare systems were constructed. From
the late 19th century through the early 20th century, the first medical colleges were established for organized
medical training. Further, dispensaries were established at sub-division and district level and hospitals at
provincial level were attached to medical colleges.
The present focus of public health evolved slowly across the globe. The broad foundations of public
health later evolved when Winslow defined public health as “the science and art of preventing disease,
prolonging life, and promoting health through the organized efforts and informed choices of society,
organizations, public and private communities, and individuals.” 1
With the emerging recognition of public health, government-initiated efforts towards formal training in
public health. The public health workforce consisted of personnel from both medical and non-medical
backgrounds that included ANMs, nurses, midwives, sanitary inspectors, sanitary assistants, health officers,
and physicians. In 1946, the Health Survey and Development Committee (Bhore Committee) recommended
the establishment of health Centres for providing integrated curative and preventive services.
Primary health care gained prominence in 1978 following an international conference in Alma-Ata. The
primary health care approach is based on principles of social equity, nation-wide coverage, self-reliance,
intersectoral coordination, and people’s involvement in the planning and implementation of health
programmes in pursuit of common health goals. The Declaration of Alma-Ata stated that primary health
care is an important parameter for achieving an acceptable level of Health for All by 2000. As a signatory to
the Alma-Ata Declaration, the Government of India, has pledged itself to provide primary health care.
With Article 21, Constitution of India guarantees that no person shall be deprived of their life or personal
liberty. “Life” here is neither the mere physical act of breathing nor connotation of continued drudgery
through life. It has a much wider meaning which includes right to live with human dignity, right to livelihood,
right to pollution free air and right to health. Article 47 enforces the government’s commitment further by
directing the State to raise the level of nutrition and the standard of living and to improve public health.
The 30th World Health Assembly resolved in May 1977, that the main social target of governments and WHO
in the coming decades should be the attainment by all citizens of the world by the year 2000 of a level of
health that would permit them to lead a socially and economically productive life. The Alma-Ata Declaration
called on all governments to formulate national policies, strategies and plans of action to launch and sustain
1
Ahmed F U. Defining public health. Indian J Public Health [serial online] 2011 [cited 2021 Jul 18];55:241-5. Available from: https://www.
ijph.in/text.asp?2011/55/4/241/92397
Background | 1
primary health care as part of a national health system. It was left to each country to innovate, according to
its own circumstances to provide primary health care.
This was followed by the formulation and adoption of the Global strategy for Health for All by the 34th World
Health Assembly in 1981. Health for All means that health is to be brought within the reach of everyone in a
given community. It implies the removal of obstacles to health - that is to say, the elimination of malnutrition,
ignorance, disease, contaminated water supply, unhygienic housing, etc. It depends on continued progress
in medicine and public health. The foundation for Universal Health Coverage is a universal entitlement to
comprehensive health security and an all- encompassing obligation on the part of the State to provide
adequate food and nutrition, appropriate medical care, access to safe drinking water, proper sanitation,
education, health-related information, and other contributors to good health.
Primary Health Care spans across the lifespan of a person and is based on principles of social justice, equity
and right to health and in recognition of the fundamental right to the highest attainable standard of health,
echoing Article 25 of the Universal Declaration on Human Rights. It is an integral part of overall social and
economic development in addition to catering to the healthcare needs of the country. Primary health
care strives to provide affordable, accessible, practical, quality and socially acceptable healthcare to the
community
To meet all these national and international commitments, it is essential for public health facilities to deliver
quality services through defined standards known as the Indian Public Health Standards (IPHS). It provides
guidance on the health system components such as infrastructure, human resource, drugs, diagnostics,
equipment, quality and governance requirements for delivering health services at these facilities.
In the year 2005, National Rural Health Mission (now National Health Mission) was launched for “attainment
of universal access to equitable, affordable and quality health care services, accountable & responsive to
people’s needs, with effective inter-sectoral convergent action to address the wider social determinants of
health”.
Also, recently the Astana Declaration in October 2018 endorsed

NHP-2017 proposes key policy
emphasizing the critical role of primary health care around the world. shift from selective primary
The declaration aims to refocus efforts on primary health care to ensure care to assured comprehensive
that everyone everywhere is able to enjoy the highest possible attainable primary care with linkages to
referral hospitals.
standard of health.
To address the morbidity burden and the social determinants, increased community participation,
surveillance, health promotion, engaging with information technologies (IT) and for ensuring continuum of
care; the Government of India implemented the holistic programme “Ayushman Bharat”, which comprises
of two inter-related components. The first component involves upgradation of all the Sub Health Centres
(SHCs), Primary Health Centres (PHCs) and Urban Primary Health Care Centres (UPHCs) to Health and
Wellness Centres (HWCs) for the delivery of comprehensive primary health care. The second component
comprises of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY) which aims to provide financial
protection for secondary and tertiary care to socially vulnerable and low-income households. Thus, together,
the two components of Ayushman Bharat will enable the country to achieve Universal Health Coverage and
eventually “Health for All”.
The HWCs will provide an expanded range of services beyond the selective package of health care for pregnant
women, children, reproductive health and communicable diseases. These HWCs will also deliver Preventive,
Promotive, Curative, Rehabilitative and Palliative care services close to communities with the principle being
‘time to care’ to be not more than 30 minutes from the farthest village. The HWCs are envisaged to provide
clinical management for most common ailments, prompt referral to doctor or for specialist consultations
at higher facilities and undertake follow-up of down referrals. To achieve this, an understanding for local
2 | INDIAN PUBLIC HEALTH STANDARDS | Health and Wellness Centre - Sub Health Centre
health needs, cultural traditions and social status of the population being catered by HWC are important
parameters for effective service delivery.
For effective and quality delivery of comprehensive healthcare services, it is essential for public health
facilities to adopt uniform standards and norms. To comply, the Indian Public Health Standards (IPHS) for
Sub-Centres, Primary Health Centres, Community Health Centres, Sub-District and District Hospitals, were
published in 2007 and revised in 2012 as the reference point to provide standardized public health care
services and general principles for infrastructure planning and up-gradation of health facilities as per the
population of the States and UTs. The defined uniform standards had been envisaged to deliver quality
services to citizens with dignity and respect and provide guidance on the health system components such
as infrastructure, human resource, drugs, diagnostics, equipment, quality and governance requirements for
delivering seamless health services at these public facilities.
Background | 3
2
Section
Introduction
Primary health care is based on principles of social justice, equity and right to health and in recognition
of the fundamental right to the highest attainable standard of health, echoing Article 25 of the Universal
Declaration on Human Rights. It is an integral part of overall social and economic development in addition to
catering to the healthcare needs of the country. HWC-SHCs/UHWCs strive to provide affordable, accessible,
practical, quality and socially acceptable healthcare to the community and is universally available, regardless
of their economic stature or payment capacity. Primary healthcare services in India are currently being
delivered through Sub-Centres and Primary Health Centres in rural areas and Urban Primary Health Centres
in urban areas.
Since the last revision of the IPHS in 2012, a number of new initiatives, interventions and programmes have
been introduced in the public health system of India. The introduction of comprehensive primary health
care through upgraded sub-centres and PHCs (now known as Health and Wellness Centres), and similarly, in
urban areas, Urban Health and Wellness Centres, specialty UPHCs (polyclinics), are some of the new additions.
Focus on urban health came during RCH-I and continued in RCH-II as part of NRHM. However, it was in 2013,
while reorganizing National Health Mission, that the National Urban Health Mission (NUHM) was launched
with the aim to provide affordable primary healthcare through UPHCs, UCHCs and outreach services to the
urban population in India. Recently, Urban HWCs have been planned to set up with a population norm of
15,000-20,000 in Urban areas to enable a robust decentralized delivery of primary health care services closer
to people, thereby increasing reach of the public health systems to the vulnerable and marginalized.
Since then, some key policy shifts have been proposed under National Health Policy (2017) for public health
care delivery system in the following areas:
yy Clinical care – from stand–alone curative to a preventive, promotive and rehabilitative approach for
achieving comprehensive wellness in health.
yy Primary care – from selective care to assured comprehensive care with linkages to referral hospitals.
yy Drugs, diagnostics, and emergency services - from user fees and cost recovery to assured free
drugs, diagnostic and emergency services to all in public hospitals.
yy Infrastructure and human resource development– from normative approach to targeted
approach to reach under-served areas with “time to care approach”.
yy Urban health– from token interventions to on-scale assured interventions to organize Primary
Health Care delivery and referral support for urban poor. Collaboration with other sectors to address
wider determinants of urban health is advocated.
yy National health programmes- integration with health systems for programme effectiveness and in
turn contributing to strengthening of health systems for efficiency.
In the public health sector, the Sub Health Centre (SHC) and Urban Health and Wellness Centre (UHWC) are
the most peripheral and first points of contact between the primary health care system and the community
in rural and urban areas, respectively. These health facilities act as an interface with the community at the
grass-root level, providing all the comprehensive primary health care services. The purpose of the SHC and
UHWC is largely preventive and promotive, but they also provide a basic level of curative care.
To account for the above-mentioned developments and in light of newer advances in health, science,
and technology, it is critical to update the IPHS by incorporating the stakeholder inputs on the existing
standards’ relevance and utility, so that the revised IPHS 2022 stay fit-for-purpose. Hence, the revised IPHS
guidelines 2022, define the norms for public health facilities in rural and urban areas to set benchmarks
towards achieving the goal of universal health coverage.
The IPHS 2022 guidelines have been framed for-

yy District Hospitals (DH) & Sub-District Hospitals (SDH),
yy Community Health Centres (CHC) – rural and urban,
yy Health and Wellness Centre - Primary Health Centres (PHC) – rural and urban, including Multispecialty
UPHC (Polyclinics)in urban areas
yy Health and Wellness Centre–Sub Health Centre-Health and wellness centre -rural (HWC-SHC) and
Urban Health and Wellness Centres (UHWC)
Additionally, the 2022 revised guidelines emphasize on the services to be delivered at each level of facility.
The service delivery defined for each level of health facility will be the basis for developing other health
system strengthening components viz. infrastructure, human resources, drugs, diagnostics/equipment,
quality improvement, monitoring/supervision, governance, and leadership. These services are envisaged
to be acceptable, accessible, affordable, and responsive to the needs of the population, especially the
vulnerable and marginalized to maintain equity in the healthcare distribution.
The 2022 IPHS norms will retain the earlier approach of supporting government health facilities to
attain a minimum acceptable functional standard (indicated as ‘essential’) while striving and aspiring for
improvement (indicated as ‘desirable’) so as to accelerate India’s progress towards achievement of Universal
Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG3) in alignment with the National Health
Policy 2017. The desirable services are over and above the essential services.
Indian Public Health Standards- Volume IV lays out norms for Health and Wellness Centre (rural HWC-SHCs
and urban HWCs) for delivering the comprehensive primary health care services. It aims to support States
with implementation of IPHS 2022 at public health facilities and includes the general principles to be followed
while applying the norms. It considers health service provision holistically for a district and implementation
of norms should be based on the local burden of disease and its projection in terms of likely future trends.
Introduction | 5
3
Section
Objectives of IPHS for
HWC-SHC and UHWC
The broad objectives of the Indian Public Health Standards (IPHS) for HWC-SHC and UHWCs include the
following:
1. To define uniform benchmark to ensure high quality services that are accountable, responsive, and
sensitive to the needs of the community.
2. To specify the minimum assured (essential) and achievable (desirable) services that are expected to
be provided at different levels of public health facilities.
3. To provide guidance on health systems strengthening components which includes architectural
design of facilities, human resources for health, drugs, diagnostics, equipment, administrative and
logistical support services to improve the overall health related outcomes
4. To achieve and maintain an acceptable standard of quality of care at public health facilities
5. To facilitate monitoring and supervision of the facilities
6. To provide guidance and tools for governance, leadership and evaluation.
Types/Categories of
HWCs 4
Section
In comparison with the IPHS guidelines of 2012, the revised IPHS 2022 guidelines classify the HWCs as:
1. Health and Wellness Centres - Primary Health Centre:
a) HWC-PHC in rural areas
b) HWC- UPHC in urban areas
2. Health and Wellness Centres - Sub Health Centre:
a) Health and Wellness Centre - Sub Health Centre in rural areas
b) Urban Health & Wellness Centre in urban areas
Types/Categories of HWCs | 7
5
Section
Population Norms for
HWC-SHC and UHWC
i. HWC-SHC (rural): In rural areas, one Sub Health Centre is established for every 5000 population in plain
areas and 3000 population in hilly/tribal/desert areas.
ii. UHWC (urban): In urban areas one Urban-HWC per 15,000-20,000 population caters predominantly to
poor and vulnerable populations, residing in slums or other such pockets.
Population norm for HWC-SHC/UHWC
S. No. Type of PHC facility Plain (population) Hilly/Tribal(population)
1 HWC-SHC 5000 3000
2 UHWC 15,000- 20,000 -
General Principles 6
Section
yy IPHS defines the standards in the local context of the country and its implementation is the State’s/UT’s
responsibility with technical support from MoHFW. IPHS does not define the implementation process.
However, in the interest of rendering quality patient services, it suggests that in-house hiring of clinical
and critical staff should be prioritized rather than those services which can efficiently be run even
through outsourcing model like security, cleaning, laundry, etc.
yy While planning and designing services at public health facilities, health needs of the entire district should
be considered as a whole rather than focusing on individual facilities within that district. This holistic
assessment should include estimating the burden of disease in the district based on previous years data
generated/research papers/surveys, the local epidemiology and the specific needs and requirements of
communities in different parts of the district. While placing services at various levels, the “continuum of
care” approach needs to be ensured for the population.
yy For each district/city, the final number of health facilities will be influenced by its population, time to
care, geographical need, local epidemiology and burden of disease, community requirements and the
health seeking behavior of the population. Every district should have a district health action plan, with
all health facilities identified and mapped, and indicating the type and level of services they provide.
yy Depending on the services provided at a particular facility, it may be deemed as a primary or secondary
care service provider facility:
¾¾ Health and Wellness Centres (HWC-SHC, UHWCs and PHCs), in both rural and urban areas will
provide primary care services.
¾¾ Multispecialty polyclinics nearer to the community will provide ambulatory specialist services,
particularly in urban areas.
¾¾ Community Health Centres in rural areas can be either FRU or non- FRU, depending on the
range of services provided. In urban areas, CHCs will provide services at par with FRU.
¾¾ District and Sub-District Hospitals will provide secondary care services.
yy Implementation of all national programmes at individual facilities must be in line with the latest GoI/
state guidelines developed for that programme.
yy Requirements of individual national health programmes (in terms of service delivery, infrastructure,
human resources, drugs, and diagnostics) have been reviewed and included in IPHS. Therefore, achieving
IPHS compliance would go a long way in fulfilling the requirements of various health programmes.
yy The Urban-HWC would be the first port of call for residents in urban areas. It would be linked to the
nearest UPHC-HWC (at population of 50,000) for administrative, financial, reporting, and supervisory
purposes.
yy All Rural and Urban-HWCs should have a National Identification Number (NIN-Id) and register on the
AB-HWC portal.
yy The specific set of services to be provided at a particular facility should be clearly identified from the
list of services provided in the IPHS norms. Requirements of individual national health programs have
General Principles | 9
already been considered in this list. This will help to identify requirements for infrastructure, human
resources for health, drugs, diagnostics, and equipment.
yy All statutory and regulatory standards relevant to a particular facility should be followed and adhered to
in accordance with the latest national/state guidelines, rules, and regulations.
yy A Citizens’ Charter should be prominently displayed near the entrance of the facility. This should provide
information about the various services being offered, timings, responsibilities of patients and providers,
details of referral vehicles and facilities, the number of free drugs and diagnostics being provided and
other citizen friendly information. Patients’ rights should be ensured, and they should also be made
aware of their responsibilities (e.g., to keep the facility clean and avoid spitting, avoiding over-crowding
by attendants, respecting visiting hours, not causing any harm to public property or indulging in violence
against healthcare professionals, etc.). A sample citizens’ charter is placed at Annexure 1.
yy All HWCs should have branding as per the GoI guidelines. IT infrastructure should be set up to enable
teleconsultation services and reporting on the respective databases.
yy Referral mechanism should be displayed at the HWCs highlighting the details of the nearest health
facilities.
Criteria for IPHS
Compliance 7
Section
For any public health facility including HWC to be considered as compliant with IPHS norms, a minimum
standard for both the quantity and quality of services should be achieved. A facility will be deemed as IPHS
compliant if it fulfils the criteria that it provides all the ‘essential’ services identified for that level of facility
rendered through requisite Infrastructure, Human Resources for Health, Medicines and Equipment.
The norms for service provision, infra-structural and human resource requirements, drugs, diagnostics and
equipment, quality assurance, monitoring and governance will apply uniformly across all facilities in rural
and urban areas. General guidance on these components is presented in the sections that follow.
The mechanism and criteria for IPHS certification can be accessed at the link given below.
https://nhsrcindia.org/IPHS2022
Criteria for IPHS Compliance | 11

8
Section
Service Provision
Health and Wellness Centres have an important role in the prevention of The services envisaged- health
several disease conditions, including non- communicable diseases and promotion, early identification,
health promotion. They go beyond first contact care and mediate an ensuring treatment, follow-up,
assured two-way referral service to primary and secondary level facilities. ensuring continuity of care by
appropriate referrals.
They also play an important role in undertaking public health functions
in the community leveraging the frontline workers and community platforms. They are envisaged to deliver
people Centred, holistic, equity sensitive, quality response to people’s health needs through a process of
population enumeration, regular home and community interactions and improving people’s participation.
A community based participatory approach which ensures preventive and promotive actions for health is
considered as one of the primary objectives of these Centres.
The healthcare services to be provided at these Centres include health promotion, early identification,
ensuring treatment adherence, follow-up care, ensuring continuity of care by appropriate referrals, optimal
home and community follow-up, disease surveillance, and health promotion and prevention for the
expanded range of CPHC services. The twelve packages envisaged under CPHC are:
1. Care in Pregnancy and Childbirth.
2. Neonatal and Infant Health Care Services
3. Childhood and Adolescent Health Care Services.
4. Family Planning, Contraceptive Services and other Reproductive Health Care Services
5. Management of Communicable Diseases: National Health Programme
6. Management of Common communicable diseases and outpatient care for acute simple illness and
minor ailments
7. Screening, Prevention, Control and Management of Non-communicable Diseases
8. Care for Common Ophthalmic and ENT Problems
9. Basic Oral Health Care
10. Elderly and Palliative Health Care Services
11. Emergency Medical Services including Burns and Trauma
12. Screening and Basic Management of Mental Health Ailments
In addition to providing clinical services, HWCs are also to be utilized as a platform for teleconsultation and
expanding the range of diagnostics. As defined in this guideline states can add more tests in hub & spoke
model with a nearest CHC/UCHC if range of diagnostics is to be expanded particularly in urban areas.
To ensure continuum of care, assured referral with facility readiness to manage referred cases must be
established with the PHC/UPHC and secondary level facilities in rural and urban areas. The referral transport
network should have the requisite number of equipped ambulances (depending on population norms) and
adequately trained human resources.
Apart from other services, an integration of Yoga and AYUSH services as appropriate to people’s needs are
required for provision of all-inclusive health services. The emphasis on health promotion (including the
School Health and Wellness Ambassador Initiative) for public health action through active engagement and
capacity building of community platforms, elected representatives and community volunteers is envisioned.
Besides facility-based services, HWCs play an important role in community outreach, which will be a part
of the service package at HWCs (e.g., VHNDs/UHNDs). Need based outreach sessions can be conducted
without any fixed periodicity (at required intervals), depending on national program requirements and
for inter-departmental convergence activities from time-to-time basis in any particular area. Program
specific outreach camps for screening and early detection of diseases such as TB, leprosy, fever, hypertension,
diabetes, asthma, glaucoma, blindness, etc., special health drives, vaccination drives, health camps for disease
specific awareness generation or other program related activities, convergence activities with other
departments for health promotion/awareness generation by addressing social determinants of health such
as sanitation, water, gender issues, violence, substance abuse, etc., public health surveillance, outbreak
investigation in case of any outbreaks, epidemics and pandemics, Disaster mitigation/ disaster management
activities in case of floods, droughts, earthquakes, landslides, etc., targeted interventions for migrants
population sub groups residing in urban areas are some of the examples of such outreach sessions.
All infrastructure plans and human resource requirements should be based on the range of services to be
provided at that facility.
The services to be provided at both types of facilities are identified as ‘essential’ and ‘desirable’. The former
includes those ‘minimum assured services’ that every facility at that level must provide. Desirable services
are those that a facility should aspire to ultimately achieve (if not already being provided) over a period of
time depending on the needs of community. Thus, desirable will be over and above the essential services.
Service flow at UHWC

yy The suggestive flow of services as mentioned below should be followed at UHWC for IPHS recognition-
yy Enquiry  Registration  Waiting Area  Doctor’s Consultation Room  Laboratory  Doctor’s
Consultation Room  Pharmacy  Exit.
Details of the services to be provided by HWCs are mentioned at Annexure 2.
Collaboration with other sectors have also been identified and listed for certain services such as nutritional
support with the WCD department, school health with the education department and vector control
activities with the ULBs/PRIs.
8.1. INFRASTRUCTURE
All the HWCs should be located such that they are easily accessible by the rural/urban communities which
they target to serve. Planning and provision of HWC-SHC and UHWCs takes into account factors affecting
access such as geographical spread, access within the community, road connectivity and the ‘time to care’
approach (within 30 minutes of reach).
The Urban HWCs should be located preferably within 1 kilometer

Selection of site for construction of
radius from the periphery of under-served population in urban HWC-SHC and UHWCs should take
slums, vulnerable pockets, and temporary settlements in cities and into account access issues such as
peri-urban areas, which are the prime focus in the urban areas. geographical spread, access within
the community, road connectivity and
Moreover, the HWCs should be prioritized in the aspirational, tribal,
the ‘time to care’ approach (within 30
and backward blocks / districts. As far as practical, while choosing the minutes of reach).
location for construction/establishment of new Centres, places like
landfill sites, water treatment plants, industrial areas, etc., should not be in the vicinity of HWC.
Service Provision | 13
New infrastructure in rural areas should be planned, designed, and built taking account of future expansion –
both with regards to the quantity and range of services to be provided.
The infrastructure for all facilities should follow the rules and regulations as laid down in the state by-laws and
the associated National Building Code.
The UHWCs may function in rented building or any pre-existing public building in that area, provided the flow
and range of services are possible with in the infrastructure available. If required, the existing infrastructure
can be modified to suit the requirements. Sufficient space and infrastructure should be provisioned for the
services being provided.
Old and dilapidated facilities may need to be demolished to build new infrastructure at the same site.
However, while demolishing any old building, it should be ensured that alternate arrangements are made for
effectively running the existing services. Factors to be considered while building a new facility or selecting
a new site for a facility include:
yy Accessibility to the community (with good road connectivity). Ideally, it should be located within the
habitation while ensuring safety of health care providers.
yy The facility is not in a low-lying flood prone area.
yy It is adequately serviced by public utilities such as water, electricity and telephone connectivity,
sewage, and storm-water disposal. In areas where these are not available, appropriate substitutes
should be identified, alternative source of electricity like Solar panels or inverter for power backup
to ensure constant electric supply for telephone and internet connectivity.
yy Ensuring elderly and disabled friendly access.
yy Minimizing exposure to air, noise, water and land pollution and vector-breeding / vector proof
buildings.
yy Reviewing land utilization in adjoining areas, the general topography, proximity to the local bus
stands, railway station and other modes of transport and obtaining the necessary environmental
(including seismic safety), fire safety and administrative clearance.
yy The state and area specific by-laws and rules should be strictly adhered to.
Infrastructure planning of HWC-SHC and UHWC should ideally be as per standard layout plan (Annexure 3).
While maps for the general lay-out, flow and suggested dimensions are provided for facility, these may have
to be adapted to fit space constraints.
At times, the availability of land is a challenge, so the possibility of vertical expansion can be considered,
especially in urban areas. However, for a facility (HWC-SHC/UHWC) to be IPHS compliant, sufficient
space along with services as prescribed in these guidelines should be provisioned for.
For already existing facilities, the flow of services needs to be ensured as per the standard plan and if required,
additional infrastructure to meet the deficiencies can be created. As far as practical, the principles suggested
above can be built in for all new constructions and to the extent possible for existing infrastructure. Priority
needs to be given for making infrastructure climate resilient, elderly and disabled friendly, etc.
The foundation of the health facility infrastructure should be strong enough to meet the requirements of
the seismic zones of that area and any future vertical expansion. It should strictly adhere to the statutory fire
safety norms. An open area to facilitate the management of disasters and emergencies is also recommended.
Emphasis should be given to create a positive, client friendly ambience and environment around the facility.
This includes due consideration to the provision of facilities for initial screening and holding area, patient
registration, waiting areas, clear wayfinding and sign-posting, parking, gardens, washrooms, drinking
water, elderly and disabled friendly facilities. Processes such as registration and drug dispensing should
14 | INDIAN PUBLIC HEALTH STANDARDS | HEALTH AND WELLNESS CentreS- HWC-SHC/UHWCS

be computerized. The facility should be environment friendly with scope for adequate natural light, water
harvesting and solar energy, as appropriate. Adequate hand washing facilities near entrance, examination
and patient waiting areas should be provided.
Infrastructural requirements for certain support services are common to all facilities. General principles to
bear in mind are presented here.
8.1.1. General Appearance and Upkeep

All the facilities should have a boundary wall with adequate lighting to ensure that the facility is clearly
visible from the approach road and also to restrict entry of stray animals. Branding of the facility may be
done as per the GoI norms. It should be free from seepage, cracks, and broken windowpanes. There should
be no unwanted/outdated posters or hoardings on the walls of building and the boundary of the facility.
It should have provision for easy access for disabled and elderly. The floors should be anti-skid and non-
slippery.
8.1.1.1. Maintenance and upkeep

Periodic visits by public health engineers should take place to monitor the infrastructure and upkeep of the
facilities.
8.1.1.2. Wayfinding/Signage
Adequate and clear signage should be displayed on the main and connecting roads to the facility. They
should be in a font which is easily visible from a distance. A board clearly indicating the name of the facility
should be placed at the front of the facility (including in the local language). Important information such
as contact numbers (e.g., fire, police, ambulance, blood banks and referral centres) should be clearly visible.
Visit schedule of primary health care team should be displayed.
The layout of the coverage area should be displayed near the entrance. The information regarding the
nearest secondary care facilities could also be displayed at appropriate place. Safety, hazard and caution
signs should be prominently displayed at relevant places. A fluorescent fire exit plan should be considered
where appropriate. Tactile pathways should be made for visually disabled and elderly visitors.
8.1.1.3. Parking
Clear access for vehicles and ambulances should be maintained. Parking for disabled, elderly and ambulances
should be reserved and ‘no parking” for those areas should be marked.
8.1.1.4. Garden and green areas

Gardens, other green areas and open spaces give a positive, healing environment that reduces stress, anxiety
and mental fatigue. So wherever possible, identify and promote greenery and open spaces. Herbal gardens
should be promoted on the campus. Kayakalp guidelines may be referred to for maintenance of the gardens.
8.1.1.5. Environment friendly features

The facility should be environment friendly and energy efficient. Where possible, the use of rainwater
harvesting, solar energy and energy-efficient bulbs/ equipment should be encouraged by converging
resources from other ministries and local bodies (RLB/ULB). Kayakalp guidelines may be referred to for eco-
friendly facilities.
While constructing the facility building, the effect of sun, rain, wind, soil and other climatic factors which
could have an adverse effect on the building and people using it, needs to be considered, e.g., dampness
and seepage can lead to spoilage of medicines in the drug store.
8.1.1.6. Disabled and elderly friendly access

For an easy access of non-ambulant (wheelchair, stretcher), semi-ambulant, visually disabled and elderly
people, infrastructural norms in line with the ‘Guidelines and Space Standards for barrier-free built
environment for Disabled and Elderly Persons’ of the Government of India should be followed. Provisions
of the ‘Persons with Disability Act’ should be implemented. These should be retrofitted in facilities currently
lacking these provisions.
In order to support the needs of visually challenged visitors, it is also advised that tactile signs be placed
with good contrast between letters and background. It is recommended to install one/two rows of tactile
guiding blocks along the entire length of the proposed accessible route. Care shall be taken to ensure that
there are no obstacles, such as trees, poles or uneven surfaces, along the route traversed by the guiding
blocks. Provision of ramp with railing to be made for use of wheelchair/stretcher trolley, wherever feasible,
should be ensured.
8.1.1.7. Disaster and emergency preparedness

All health care facilities should be resilient to climatic and environmental changes. They should also be
capable to handle sudden healthcare needs during disasters and unforeseen emergencies /epidemics/
pandemics etc. While creating infrastructure seismicity of zones needs to be considered. Wherever the
health facilities are already existing possible retrofitting should be planned.
Healthcare facilities shall be inspected by competent licensed engineers after every damaging earthquake to
document damages (if any) to Structural Elements (SEs) and Non-Structural Element (NSEs) of the buildings,
along with recommendations for detailed study and suitable retrofitting as found necessary. Protocols for
these should be present in all facilities. Detailed norms for Disaster Preparedness and safe electricity are
placed at Annexure 4.
All staff should be trained on relevant disaster prevention and management procedures along with climate
and environment resilient features. Structural and non- structural earthquake proof measures (in line with the
State Govt. guidelines) should be incorporated. These include simple non-structural measures like fastening
of shelves, almirahs and movable equipment, etc., as appropriate. Similarly, in flood prone areas, structural
provisions like raise floor, sloping RCC roof for too quick rainwater drainage, etc. should be factored in.
8.1.1.8. Fire safety

Measures as per state and central government guidelines for fire regulations should be ensured while
planning for HWC. Availability of open spaces, clearly visible fire exits with proper illumination and lighting
(even during interruption in electric supply), and fire extinguishers are some of the important considerations
for creating fire safe infrastructure.
As a principle, none of the fire exit doors should be kept locked. These doors should be fire resistant and
can be opened outwards with a push bar system on the doors. Fire detectors, extinguishers, sprinklers, and
water connections for the water should be functional and easily accessible. Periodic monitoring and audit
for fire safety including drills should be organized and conducted. The facility should have an identified
nodal officer for ensuring fire safety.
All healthcare facilities should be so designed, constructed, maintained, and operated as to minimize the
possibility of a Fire emergency requiring the evacuation of occupants, as safety of hospital occupants
cannot be assured adequately by depending on evacuation alone. Hence measures shall be taken to limit
the development and spread of a fire by providing appropriate arrangements within the hospital through
adequate staffing & careful development of operative and maintenance procedures consisting of:
(1) Design and Construction.
(2) Provision of Detection, Alarm and Fire Extinguishment.
(3) Fire Prevention
(4) Planning and Training programs for Isolation of Fire; and
(5) Transfer of occupants to a place of comparative safety or evacuation of the occupants to achieve
ultimate safety.
8.1.1.9. Electric supply

The public health facilities should have access to adequate, and reliable electricity supply. Adequate number
of electric points on various walls (at < 1.5 m height from the floor) need to be ensured for easy connection.
Use of explosion proof plugs, plug connector and socket is essential to ensure safety against explosion.
New electrical appliances should have a minimum 3-star rating from Bureau of Energy Efficiency or equivalent
recognized organization to minimize the energy input. Use of low-energy LED lighting or alternate low-
energy option to save indoor lighting energy cost is recommended. Apart from the above, health care facility
should ensure the following recommendations given by National Building Code 2016 (4.5.2-subdivision C-1):
yy Appropriate power backup/inverter should be in place to ensure that there is no disruption of
services, and cold chain for vaccine and diagnostics is properly maintained. Two number of earthing
should be there at each electrical installation. Copper plate earthing should be preferred.
yy Provision of surge protection/suppressor should be there. Surge suppressors are rated according
to size of voltage spike they can handle, so only units of high enough joules rating to protect the
equipment should be used.
yy Load calculation should be proper, accordingly the distribution, electrical switch gear rating,
circuitry, cabling, and electrical installation should be there.
yy The size of cabling and wiring should be about 1.5 times or more to the actual electrical load
calculated.
yy Adequate power back up with another source such as DG, Photovoltaic etc. should be there in
synchronization with the first source.
yy For some places which are very important, provision of uninterrupted power supply should be
ensured.
yy Phase sequence should be proper as for motorized load.
yy Load monitoring should be there to avoid any overloading.
yy A lot of motorized as well as semiconductor material devices are there hence provision of power
factor improvement should be there.
yy All the connections and joints should be tight with proper size of thimbling.
yy Balancing of electrical load should be proper and monitored via measuring devices.
yy Suitable place should be selected for electrical installation.
yy Sensitive equipment should be provided with proper rating UPS for extra safety against disturbances
as voltage spike and noise.
yy The Electrical Switch Room shall be housed in a dedicated room/ cupboard located on the ground
floor and in association with an external wall and shall have internal access. The room shall be located
so that it does not present difficulties for services distribution from adjoining spaces or rooms, and
it shall be located to provide for economic distribution of services. The main switchboard shall be
of metal clad cubicle design as per approved standards and regulations. Each switchgear assembly
shall have sufficient spare capacity. Electronic surge protection shall be provided on the incoming
mains. Periodic electrical audits by engineers should take place.
8.1.1.10. Illumination
The minimum intensity required in general OPD area is 150 lux. Medicine store and laboratory should have
an intensity of 300 lux. Emergency portable light units should be provided. These illumination requirements
should be as prescribed by Bureau of Indian Standards (BIS).
8.1.1.11. Water Supply

Arrangement should be made for round the clock piped soft water supply along with an overhead water
storage tank with a provision to store at least 3 days water requirement. It should have pumping and boosting
arrangements. Drinking water can be harvested from spring, well or borehole and should be treated before
consumption so that it becomes potable. Untreated water can be utilized for gardening and flushing of
toilets etc. Requirement of water supply for firefighting needs to be considered while planning for total
water capacity of a health facility.
8.1.1.12. Drainage and Sanitation

The construction and maintenance of drainage and sanitation system for wastewater, surface water, sub-
soil water and sewerage shall be in accordance with the prescribed standards. This is particularly important
in the UHWCs located in urban slum areas where availability of adequate drainage mechanism should be
ensured within and around the health facility. Water harvesting is one of the most critical components
to the challenge of climate change and thus should be focused upon. Reuse of wastewater in irrigation,
cooking, cleaning and washing, etc. can be demonstrated in villages and urban slums for orientation of the
community.
8.1.1.13. Waste management

All such waste which can adversely harm the environment or health of a person is considered as infectious
and termed as Bio-Medical Waste (BMW). Every health care facility should ensure appropriate collection,
transportation, treatment, and disposal of bio-medical waste as per the latest Bio Medical Waste Management
Rules (BMWM). Each Healthcare facility should ensure that there is a designated central waste collection
room situated within its premises for storage of bio-medical waste till the waste is picked. Availability of
dedicated biomedical waste disposal facility/deep burial pit along with septic tank and soaking pit should
be ensured in the health and wellness centres. Panchayat/ULB should make arrangements for disposal of
general/municipal waste. It should also be ensured that disposal of human anatomical waste, soiled waste
and biotechnology waste is done within 48 hours.
As per Biomedical Waste Management Rules & Guidelines 2016, deep burial pits need to be constructed only
at such HWC-SHC/UHWCs where the common biomedical treatment plant is situated at a distance of more
than 75 kms. Before disposal of biomedical waste in the pits the facility needs to ensure that biomedical
waste is decontaminated and shredded. This will be carried out with prior approval from the prescribed
authority and as per the Standards specified in Schedule-III.
General waste consists of all the waste other than bio-medical waste, which has not been in contact with
any hazardous or infectious, chemical, or biological secretions and does not include any waste sharps. Such
waste is required to be handled as per Solid Waste Management Rules and Construction & Demolition Waste
Management Rules, as applicable.
Liquid waste management is another area which needs adequate attention and for smaller health care
facilities the liquid waste and effluents can be treated in the area where it is generated, before disposal
in drainage system. Other wastes consist of electronic equipment, used batteries, and radio-active wastes
which are not covered under biomedical wastes but have to be disposed as and when such wastes are
generated as per the provisions laid down under E-Waste (Management) Rules, Batteries (Management &
Handling) Rules, and Rules/Guidelines under the latest Atomic Energy Act, respectively.
Subsequent to general principles for infrastructure, following considerations should be kept in mind while
planning for infrastructure of clinical services.
8.1.1.14. Infection Prevention & Control

With the rising need to practice infection and prevention control measures at individual, community and
facility level, infrastructural design of the health and wellness centres should be such that it facilitates
practicing infection prevention protocols like physical distancing, handwashing, mask distribution, PPE
donning on & off, etc. Color-coded bins should be available in every service area including patient waiting
areas so that waste can be segregated at source.
8.1.1.15. Infrastructure for Clinical Services

1. Screening and Holding Area
Before entering for registration, the HWC should have enough space (either open or closed) to hold and
undertake preliminary screening, if need be, for any symptom of infections which can quickly be transmitted
specially during epidemics and pandemics.
2. Registration
Every HWC should have facilities for computerized registration of cases coming to OPD. This can be done
during OPD consultation by CHO or any other designated staff in SHC in rural areas and by ANM/Other
support staff in UHWCs.
3. Waiting area
Adequate seating arrangement preferably, which are less space occupying and easy to maintain should be
placed. Messages conveying people to provide seats to elderly, pregnant women, disabled persons, children,
adolescents, and patients should be properly displayed.
Adequate space should be allocated for persons using mobility devices, for example wheelchairs, crutches
and walkers, white cane, etc., as well as those walking with the assistance of others. Waiting area for OPD
should have a patient friendly ambience and can have colorful wall paintings.
Patient amenities in waiting areas should include:
Essential amenities
yy Fans
yy Clean drinking water
yy Clean and gender sensitive toilets
Desirable amenities Handwashing areas, mask
yy Air-conditioning distribution counters, bio-
medical waste storage and
yy Television/LCD in waiting area displaying facility related disposal areas need to be clearly
information, health related IEC marked in the facility.
4. Consultation room
The consultation room should have enough space to accommodate table and at least two chairs, where
interaction with patients can be undertaken with confidentiality and dignity. It should be well lit and
ventilated.
An examination table, curtains (wheeled, wall mounted, single piece), hand washing facilities should be
provided, as needed.
5. Health and Wellness Area
Wellness area should be preferably located near the entrance of the facility and with a capacity to
accommodate 18 - 20 persons at a time so that wellness activities can be carried out easily.
6. Clinical Laboratory
The laboratory should have equipment and reagents for conducting all tests enumerated to be provided
at the level of Health and Wellness Centre. List of tests to be undertaken at the facility should be clearly
displayed. Laboratory should not be a thoroughfare and various testing areas should be clearly marked. It
should have facility for running water, testing and cleaning area and kept well maintained at all times.
7. Record keeping
Every HWC should plan to ensure safe upkeep of the necessary records preferably utilizing IT systems.
8. Day care beds
Outpatient health care services sometimes require the patient to be under medical supervision for a period
of several hours for treatment or examination or observation. Later, during evening/at night the patients
are either discharged or referred to higher facilities. For the same purpose, the HWC-SHC needs physical
infrastructure for two-day care beds.
9. Store
The HWC should have adequate and spacious stores located away from patient traffic with facility for storing
drugs, consumables, records, linen, furniture, equipment, and sundry articles. Guidelines for safe disposal of
expired drugs and vaccines should be adhered to. The store should have small space for keeping 5-7 days
stock of drugs and linen and there should be system of indenting medicines from the linked PHC/UPHC
depending upon frequency as required.
10. Teleconsultation area
Adequate space and equipment as per guidelines should be made available. Allotted space along with
internet/telephone connection will facilitate the effective delivery of telemedicine services. To optimize the
use of space, the health and wellness room can be equipped with teleconsultation facilities. IT requirements
should be set up to meet the needs of capturing, transmitting images, prescriptions, and diagnostic reports
for teleconsultations. Video calling feature should be enabled in the existing IT system to connect with hubs
identified for teleconsultation services. Minimum requirement for HWC infrastructure for teleconsultation
includes Telemedicine diagnostic kit, Desktop with headphone, Microphone and HD Web Camera, Printer,
and last mile Connectivity (minimum 2 MBPS).
11. Support Services

i. Washrooms – Gender sensitive, clean and functional toilets with regular supply of running water.
ii. Decontamination and washing facilities – The facility should be available for both linen and
equipment. Linkages with mechanized laundry at DH/CHC level can be established if required.
iii. Residential Area - All the staff should ideally be provided residential accommodation within the
health and wellness centre compound, especially in rural areas. It is important to provide staff
quarters to the incumbent staff so that the availability of services is ensured. Keeping the staff
within the campus will also ensure accessibility and safety of the premises. Well-equipped transit
accommodation facilities at larger facilities such as District Hospitals and geographically and
strategically selected SDHs and CHCs can serve as a hub for health workers of all grades posted at
nearby PHCs. Transport arrangements (such as employees led pooled shuttle service to and from
the accommodation to the facility) will allow for staff to work at remote facilities while providing
their families greater opportunities for quality education and employment. Alternatively, house rent
allowance can be provided.
12. Oxygen Supply
The COVID 19 pandemic has affected not only secondary or tertiary level of care but also the primary level.
Thus, oxygen support at HWC-SHCs/UHWCs through cylinder or concentrator is essential to manage COVID
or other patients requiring the support. However, care should be taken to store the cylinder/concentrator
carefully as per GoI guidelines.
Table: Oxygen delivery systems in HWC-SHC/UHWC
B Type (1500 Lts

Oxygen Concentrator
S. No. Facility Type Bed Capacity Oxygen Capacity.)
(10 LPM)
Oxygen Cylinder
1. HWC-SHC/UHWC 2 (Day care) 3 1
Important Note regarding Oxygen delivery systems

1. The requirement of oxygen indicated is as per the norms conveyed to the states/UTs (vide 2217044/
2021/ o/o JS (NV) file T-20017/03/2021-NCD). However, the actual requirement of the health care
facility will vary depending upon bed occupancy, oxygen uses per bed and other local considerations
including patient load.
2. While calculating the total requirements of the facility the above factors along with periodicity of
refilling needs to be considered. Ideally every facility must ensure 48 hours in house storage of
oxygen with assured refilling at regular defined periodicity.
3. For ambulances being served through National Ambulance Service network with toll free number
have in built oxygen capacity, however all stand-alone ambulances/ Patient Transport vehicle should
have two Type B (capacity of 1500 liters of oxygen) oxygen cylinder per ambulance.
4. There is a requirement of one flowmeter with pressure regulator per bed for oxygen supported beds.
5. A separate dry, well ventilated well-lit room away from the main area should be available for storage
of cylinders.
6. Oxygen cylinder refilling should be done with the nearest government facility (if available) or IOL
supported facility under MOU/price agreement.
8.2. Human Resources for Health
Apart from providing preventive and promotive services, HWCs are also the fulcrum for services related to
national/ state health programmes. Such services are envisaged to be delivered through a dedicated team
of health care workers proficient in public health and primary health care services.
An accurate, timely, reliable, and complete Human Resource Policy at the State level backed by an efficient
Human Resource Management Information System (HR-MIS) can be used for better human resource
planning and effective utilization of the existing manpower. Information and monitoring regarding postings,
deputation, transfers, training, promotion, leave, suspension, termination and retirement should be utilized
for a transparent payment and transfer system.
While planning for human resource, it is important to prioritize in-house hiring of such staff which is required
for rendering clinical services (GDMOs, CHOs, Nurses, Technicians, etc) rather than those whose services can
be outsourced like Security guard, data entry operators and other group-IV employees.
HWC-SHC
The type of staff viz Community Health Officer (CHO), Auxiliary Nurse Midwife (ANM) and a Multi-Purpose
Worker (MPW) (Male) or two ANMs, and support staff mentioned at Table has been selected taking into
consideration services and programme requirements of the HWC-SHC.
Table : HR at HWC-SHC
S. No. Human Resource required Required Numbers

1. Community Health Officer (CHO) 1
2. Multipurpose Health Worker 1 Male +1 Female
Sanitation and security services can be hired/outsourced
There should be one ASHA per 1000 population or one ASHA per habitation in tribal, hilly and desert areas
should be attached with the HWC as part of the entire team. The job responsibilities for each category of
staff are placed at Annexure 5.
UHWC:
The Urban-HWC is to be staffed with a Medical Officer, a Staff Nurse/Pharmacist, Male-MPW and one support
staff. Staff Nurses will also be supporting the doctors while examining the patients particularly the female
patients to ensure their privacy and dignity. Ideally, the ANM and ASHA are responsible for the catchment
area of a UPHC. Wherever available, they will be drawn from HWC-UPHC / UCHC for respective Urban-HWC
while their salaries can continue to be drawn from their linked HWC-UPHC. In case where ANM, ASHA are
not available, the state may engage new ASHA, ANM for Urban-HWCs depending on the local needs and
resources available.
Table: HR at UHWC
S. No. Human Resource Required Numbers
1. Medical Officer 1
2. Staff Nurse 1
3. MPW (Male) 1
S. No. Human Resource Required Numbers
4. Sanitary Staff * 1
5. Security Staff** 1
*Sanitation and security services** can be hired/outsourced
One ASHA per 2000 population and one ANM per 10000 population should be attached as part of the entire
team in urban areas.
yy IPHS 2022 has not calculated leave reserves for any level of staff. However, states have the flexibility
to determine their own level of ‘leave reserve’ to be sanctioned and this additional number of nurses
and allied health professionals can be deployed to cover for leave and absences.
yy Leave and Training Reserves of 15% or as per the state rule is recommended for all staff in IPHS.
Table: Minimum Performance Standards (HR)

S. No. Staff Break up of activities
1. Medical officer OPD = 75 patient /day
Clinical, Emergency and other duties
Supervision of Public Health and health programmes related activities.
2. CHO OPD = 20 patient /day
Tele consultations= 40-50 per month
Clinical, Emergency and other duties
Supervision of Public Health and health programmes related activities.
3. Staff nurse As per INC norms (for OPD, IPD shifts and specialist services)
4. Pharmacist 120 dispensations of prescription/day, maintain stock registers, store,
inventory management
Note: Assuming 8 hours shift and 75% productivity and efficiency, it is estimated that there will be 6 hours of working time spread over 6
days in a week
8.2.1. Capacity Building

Along with placement of qualified HRH, the States should make all efforts to continuously build on their
skills and competence as per their job requirement.
Special attention should be paid to training of CHO at the HWC-SHC as he/she not only serves as the lead
of the HWC-SHC and a clinician but has to look after the overall health of the communities and ensure
implementation of the National Health Programs in their catchment area.
Different training programs for Induction, skill building and leadership, new programs and if required,
refresher training should be planned systematically. Diligent records of all trainings attended by the HRH
should be maintained by the facility in-charge. Cross-learning should be promoted where the HRH upon
successful completion of the training program briefs the other staff about their key learnings.
8.2.2. Conduct and Behavioural Standards

The HRH placed in the public health facilities should adhere to the highest ethical and behavioral standards
and provide patient care with utmost respect for the dignity of life. It is important that states orient
health professionals to discharge their duties in a professional and courteous manner, facilitating greater
acceptability of HRH in the community as well. They should also be oriented to the concept of gender
sensitivity and efforts should be made to ensure that gender sensitivity is inculcated in their conduct and
actions.
Soft skills including an empathetic attitude, manners and courteousness at bedside should be a core
value, especially towards the marginalized and vulnerable. The privacy and dignity of patients should be
maintained, and the principles of patient confidentiality strictly adhered to dress codes (with a name badge)
and adherence to punctuality should be emphasized.
8.2.3. Safety Measures for HRH

It is crucial that the safety of the HRH providing services at all levels be ensured. For this purpose, the
following must be adhered to:
yy Sufficient provision of Protective gear like gloves, masks, gowns, caps, personal protective
equipment, lead aprons, dosimeters etc. and their use by Health Care workers must be as per the
standard protocols in place.
yy Promotion of Hand Hygiene and practice of standard precautions by Health care workers should be
standard practice.
yy Display of standard operating procedures at strategic locations in the hospital.
yy Regular Training of Health care workers in standard precautions, Patient safety, infection control and
Bio-medical waste management should be part of their training requirements.
yy Immunization of Health care workers against Tetanus, Typhoid and Hepatitis B should be ensured.
yy Provision of round the clock Post Exposure Prophylaxis (PEP) against HIV in case of needle stick
injuries should be initiated in the emergency department.
8.3. Medicines
Access to essential medicines is a major determinant of health outcomes and an integral, and often crucial
component of health care. An approach to ensuring access to medicines closer to community has been
promoted through the list of Essential Medicines. It is necessary for the states to prioritize which medicines
should be made available based on the existing demographic profile and disease prevalence rate and
update the state EML. All essential medicines should be available free of cost in all HWCs under ‘Free Drugs
Service Initiative’ of GoI. For UHWC, the provisioning of medicines is to be ensured as per CPHC guidelines
for Urban-PHCs. As the list of medicines is dynamic, the recommendations made under IPHS are as per
National List of essential medicines. With the launch of universal NCD screening and comprehensive primary
health care, long-term dispensing of medicines for the management of chronic illnesses such as diabetes
and hypertension has been initiated.
Storage of medicines should be such that spoilage is minimized. Medicine stores should avoid dampness
(for example, no leaking roofs) and basic principles like ‘first expiry, first out’ for drugs and vaccines should
be followed. Storage of medicines in clinical areas should be avoided. For medicines and vaccines requiring
cold-chain storage, adequate provisions can be made. Accurate record of stock should be maintained.
Detailed List of Essential Medicines is attached as Annexure 6.
Updated list of Medicines as per EML is available at https://nhsrcindia.org/sites/default/files/202107/

H%26WC%20SHC%20and%20PHC%20updated%20EML%20as%20on%20March%202020%20-.pdf
8.4. Diagnostics
Diagnostics are an integral part of the health care system and provide information needed by service
providers to make informed decisions about care provision related to prevention, screening, detection,
treatment and management. Limited availability and access to quality laboratory and radiology services
are among the major challenges contributing to delayed or inappropriate responses to disease control and
patient management.
The testing facility at the level of HWC-SHC includes diagnostics for screening of various conditions/diseases.
Fourteen tests need to be ensured as per the list placed at Annexure 7. Since all UHWCs have MBBS doctors
so it is desirable that the access/linkages to diagnostics should be as per the list indicated for UPHC-HWC.
However, the fourteen types of diagnostics as defined for UHWC should be available in-house as essential
diagnostics.
The turn-around time for test results should also be standardized, adhered to and monitored. For specialized,
advanced and specific diagnostic tests, linkages with PHC, CHC, SDH and District Hospitals, in hub and spoke
mechanism can be established. In all cases, transportation should be managed carefully to maintain integrity
of the sample, giving due attention to temperature, preservation needs, special transport containers and
time limitations. It is also important to ensure the safety of those handling the material before, during and
after transportation.
8.5. Equipment
Medical equipment plays a significant role in patient care. It is a crucial component of health systems, as it
enables the service providers to diagnose, monitor and treat various kinds of diseases. Having appropriate
quality of medical equipment, helps to prevent patients from being denied any health services. All the
necessary equipment to provide clinical, support and other services should be meeting essential quality
parameters through the state procurement policies and procedures. The equipment mentioned under IPHS
should be included in the list of essential equipment at different levels of facilities. However, the list is not
exhaustive and additional equipment, if required, can be procured to provide the full range of services being
offered at the facility.
A systematic and robust programme for bio-medical equipment maintenance and monitoring should be
in place at all public health facilities. To improve the functionality and life of equipment, simultaneously
improving healthcare services in HWC-SHC/UHWC along with reducing cost of care and improving the
quality of care, provisions have been made in the IPHS for bio-medical engineers and technicians to oversee
equipment maintenance at public health facilities. The maintenance of medical equipment requires a wide
range of technical abilities, and the costs and time required to train a technician increases with the level of
skill that has to be attained. Training of technicians to do front-line maintenance for medical equipment in
public health facilities is essential.
An effective equipment audit assesses the present equipment status and ensures better equipment
procurement in the future. The audit should be done on a periodic basis and contain details like name, cost
of equipment, date of purchase, manufacture and installation, name and address of supplier, department
where installed, environmental control, spare parts inventory, technical manual, after sales service
agreement, guarantee, warranty period, life of equipment, depreciation per year, up/down time, date of
condemnation and replacement. Number of services delivered by each major equipment needs to be noted
down, to analyse the value for the money invested in purchasing high-cost equipment.
Along with maintenance and monitoring programme, it is also essential that a condemnation policy is in
place at all facilities so that the practice of out-of-use equipment and furniture being scattered around the
facility is mitigated. Condemnation should be done periodically by condemnation committee after careful
examination of items. The list of items with code number, the date of purchase, repair, correct value and
other relevant details should be thoroughly prepared by the committee.
Biomedical Equipment Management & Maintenance Program (BMMP) is an initiative by Ministry of

Health and Family Welfare to provide support to state governments to outsource medical equipment
maintenance comprehensively for all facilities so as to improve the functionality and life of equipment,
simultaneously improving healthcare services in public health facilities- reducing cost of care and
improving the quality of care. Detailed list of equipment is placed at Annexure 8.
8.6. Quality assurance

Well maintained infrastructure, adequate & skilled human resource, functional equipment & instruments
and sufficient drugs & consumables ensure the fulfilment of the ‘Structural’ requirements for establishing a
well-functional health facility. However, for attaining enhanced satisfaction with improved clinical outcomes,
it becomes equally pertinent to ensure ‘Quality’ in the ‘Processes’ of the care within a health facility.
As a healthcare provider, while it is important to ensure provision of safe and evidence based clinical care, it
is equally fundamental to provide the care that makes patients’ and visitors’ experiences rewarding. Ensuring
‘Quality of Care’ as a key component would require undertaking conscious and concerted efforts to identify
the ‘Gaps’ by measuring the Quality of Care (QoC) in all its three dimensions, namely structure, process and
outcome (Donabedian Model of QoC).
Subsequently, available resources are channelized, and efforts undertaken for closing the gaps and bringing
about the ‘Improvement’ in the services.
For ensuring provision of ‘Quality of Care’, ISQua (International Society for Quality in Healthcare) accredited
National Quality Assurance Standards (NQAS) for District Hospitals, CHCs, PHCs and UPHCs, HWC-SHCs and
UHWCs have been formulated by the Ministry of Health & Family Welfare, GOI. Setting standards is a dynamic
process, and the standards provide roadmap for the health facilities to improve the care.
NQAS are arranged broadly into eight (8) broad themes, named as area of concerns. For micro detailing of
each standard, they are divided into Measurable Elements (ME) and further categorized into Checkpoints.
These checkpoints are objective components and together they constitute a checklist which are scored
to achieve a score (Figure Measurement system under NQAS). Health care facilities should refer to NQAS
Assessors’ guidebook and take initiative for the implementation.
Figure: Measurement system under NQAS
Checkpoints
Measurable Element
Standards
Area of Concern
National Quality
Assurance Program
A well-built institutional framework from facility (Quality team) to the National level (Central Quality
Supervisory Committee) supports the seamless implementation of the standards (Figure Institutional
Framework under NQAS). Facilities which are able to meet the defined standards and criteria are certified
and incentivized (subject to annual surveillance and ensure sustaining the changes). With this, National
Quality Assurance Program (NQAP) envisages to instill the culture of Quality and Safety in our health systems.
Figure: Institutional Framework under NQAS
National Level Central Quality Supervisory Committee
State Level State QA Committee State QA Unit
District Level District QA Committee District QA Unit
Facility Level Facility QA team
It is expected that all public health facilities would implement these standards by undertaking following
steps:
yy Base-line assessment against NQAS
yy Plan for gap closure
yy Undertake Improvement activities
yy Functional system of collating patients’ satisfaction and its analysis
yy Meeting regulatory requirement
yy Analysis of facility level key performance indicators (KPIs)
yy Quality certification, and
yy Sustenance
Summary of the activities is given in Figure.
Under the ambit of National Quality Assurance Programme, various other initiatives like Kayakalp, LaQshya,
MusQan and Mera Aspataal (My Hospital) have also been initiated to work on specific domains of quality
improvement. These domains together support the implementation of National Quality Assurance
Programme.
yy Kayakalp aims to promote Cleanliness, Hygiene, and Infection Prevention. It is an award scheme in
which facilities are assessed at three-levels (Internal, Peer, External) using objective checklist covering
eight thematic areas (a) Hospital Upkeep, (b)Sanitation & Hygiene, (c) Waste Management, (d)
Infection control, (e) Support Services(f ) Hygiene Promotion, and (g) Beyond the hospital boundary.
Facilities scoring 70% and above after external assessment are recognized and incentivized.
yy LaQshya is a quality improvement initiative, which aims to improve facility-based quality of care
around birth, which normally takes place in the Labour Room and Maternity OT of a high case-load
facility.
yy Mera Aspataal (My Hospital) an ICT based platform which captures ‘Voice of Patients’ visiting and
receiving care from the healthcare facilities. Inputs received on Mera Aspataal support facilities to
identify the “Dissatisfiers” and to take up further actions to mitigate them.
Figure: Road map for healthcare facilities to achieve NQAS certification
Patient Safety and Infection Control

Some of the patient safety and infection control measures are given below:
yy Hand washing facilities in all areas should be installed. Compliance with the correct method of hand
hygiene by health care workers should be ensured.
yy Safe clinical practices as per standard protocols to prevent health care associated infections should
be instituted. (Annexure 9).
yy There should be proper written hand over system between health care staff.
yy Safe Injection practices as per the prescribed protocol should be followed.
yy Ensuring Safe disposal of Bio-Medical Waste as per rules should be adhered to.
yy For reducing environmental pollution including those relating to Mercury, GoI Guidelines should be
adhered to.
yy Guidelines for Airborne Infection Control should be followed.
yy Regular Training of Health care workers in patient safety, infection control and Bio-medical waste
management should be scheduled and held.
8.7. Implementation of IPHS

8.7.1. Governance
Effective governance of the public health system includes the establishment of institutional arrangements
and policies along with their continuous monitoring to ensure proper implementation. Apart from promoting
good leadership, it also includes specific interventions such as building accountability in the system (e.g.
performance appraisal, target setting and monitoring, social accountability, citizens’ charter); patient
centric services (patient feedback, reducing out-of-pocket expenditure, improving the patient experience,
grievance redressal); compliance with statutory norms (Acts and regulations) and ensuring robust clinical
governance (adherence to SOPs and standard treatment guidelines, and MDSR/CDR). Some aspects of
governance relevant to public health facilities are described below:
8.7.2. Monitoring
It is assumed that rigorous monitoring, continuous support and Health & Wellness Centres will provide a
encouragement by supervisors and higher levels of management platform for co-ordination and holding
and most importantly ownership by the staff will be strengthened meetings with Gram Panchayat for planning
avenues and strategies for health promotion
as part of continuous quality improvement initiatives. Internal
related to various dimensions of primary
mechanisms include systematic and proper record keeping care.
and timely reporting. An action plan with corrective measures,
Social Audits of service provided by HWC
and timelines should be prepared and reviewed in subsequent
should be used for external monitoring.
meetings.
A variety of measures should be used for external monitoring; these include patient satisfaction surveys,
social accountability through Jan Arogya Samitis and/or Panchayati Raj Institutions, community surveys and
Jan Sunawais and Jan Samvads.
Institutional structures operational for community-based monitoring such as social accountability,

Village Health Sanitation and Nutrition Committees (VHSNC), UHNDs and Community Action for
Health – monitor delivery of preventive, promotive and curative services as part of CPHC including
through activities like social accountability. They are important to provide relevant inputs for decentralized
health planning. Along with monitoring of services at the facility level, primary health centres should
monitor and supervise activities of HWC-SC, VHNDs, ASHA, IEC/BCC, implementation of national health
programs, timely payment of various entitlements through regular meetings, periodic visits by Medical
Officer, LHV etc., checking and tracking of missed out and left out ANC/PNC, high risk pregnancies,
vaccinations, cold chain etc. Periodic reporting of the HWC performance in the monthly review meeting is
required.
8.7.3. Jan Arogya Samiti

The Jan Arogya Samiti serves as an institutional platform of HWC-SHC/UHWC and PHC-HWC/UPHC-HWC
level in both rural and urban areas, for community participation in its management, governance and ensuring
accountability, with respect to provision of healthcare services and amenities. They support AB-HWC team
in working with VHSNCs/MAS, and serve as an umbrella, providing mentorship for Health Promotion and
Action on Social and Environmental Determinants of Health, in community level activities of National Health
Programmes and other community interventions. JAS also support and facilitate the conduct of activities
pertaining to social accountability at AB-HWC in coordination with VHSNCs/MAS and act as Grievance
Redressal Platform for families who access healthcare services at AB- HWCs, ensuring availability and
accountability for quality services. JAS facilitate and support Gram Panchayats/Urban Local Bodies (ULBs) of
the area in undertaking health planning.
At the facility level, the JAS members will identify gaps related to physical infrastructure, services (essential
and desirable), human resources for health, drugs, and diagnostics at HWC level based on the prescribed
standards.
8.7.4. Accountability
The CHO at SHC and MO at the UHWC must improve effectiveness and efficiency in the system by building
mechanisms to strengthen answerability and accountability of service providers.
Feedback from the community using different methods such as patient feedback, community/social
accountability, Jan Sunwai and Jan Samwad must be encouraged, and timely and appropriate action taken
on the feedback received.
Every facility must have a Citizens’ charter displayed in a prominent place in a legible and locally appropriate
format. This should include information on the range of services offered, timings, entitlements, user
charges, rights and responsibilities of users and grievance redressal procedures. A list of the free drugs
and diagnostics provided at the facility should be readily available with MO I/c and Pharmacist for perusal
of any citizen. Ideally, the list of essential medicines and diagnostics should also be made available with
the Panchayat. The total number of essential medicines and tests should be displayed in Citizens’ Charter
as well.
8.7.5. Patient Centric Services

All necessary efforts to ensure that patients and their attendants have a comfortable, respectful and hassle-
free experience at the facility should be ensured. This includes an empathetic and compassionate attitude
towards patients and relatives in a professional manner.
8.7.6. Grievance Redressal

There should be a robust grievance redressal mechanism. Apart No user fees are charged for national
from any centralized system introduced by the state (e.g., call government funded programmes that are
centre) there should also be a method to lodge local complaints provided as a service guarantee for people
(e.g. complaints box, receipt provided for a complaint letter or accessing public sector health facilities.
an opportunity to meet the CHO). These should be acted upon
in a timely manner and feedback provided to the complainant, wherever possible. In addition, there
should be a time limit to resolve registered grievances; and if not complied with, should automatically be
escalated to the next higher level. This will strengthen efficiency, accountability and quality of services
being delivered.
8.7.7. Information and Communication Technology

Information and communication technology is essential to enable efficient service delivery at HWC.
IT system has following functions in HWC.
yy Registration/screening of the household/ Individual in the catchment area of a particular HWC
yy Records of service delivery given to the patients under different health programmes
yy Management of service delivery by registering births, deaths, disease prevalence, etc.
yy Support inventory management and supply of medicines, vaccines and consumables linked with
HWCs
yy Support biomedical equipment maintenance of all the equipment by maintaining database of all
the equipment used in HWC
yy Provide aids for recruitment as HWC Primary health team staff
yy Generate population -based analytical reports for routine monitoring and to assess performance of
health care providers
8.7.8. Intersectoral Convergence
Convergence is central for the success of health promotion strategies and requires close coordination of
health with other allied departments. While organizing health promotion activities on various dimensions
of primary care at HWCs, support of other relevant departments can be taken.
Convergence should be undertaken with:

yy Education department for School Health and Wellness Ambassador Initiatives
yy ICDS for delivery of six services, viz. supplementary nutrition, pre-school education, nutrition and
health education, immunization, health check-up and referral services at Anganwadi Centres, Village
Health, and Nutrition Days act as a platform for interfacing between community and the health
system.
yy Panchayati Raj to address spread of outbreaks of communicable diseases such as dengue,
chikungunya, malaria, for sanitation drives, vector control, controlling water coagulation through
cleaning of drains etc. and ensure participation of community during the times of disaster.
yy Ministry of Youth & Sports: Fit India and Age-appropriate fitness protocols
yy FSSAI: Eat right tool kit and diet counselling
yy AYUSH: for organizing regular yoga sessions and other wellness activities
The RLBs/ULBs would also ensure convergence with various schemes relating to the wider determinants
of health and wellness such as urban development, drinking water, sanitation, education, nutrition being
implemented by other ministries and departments.
Health & Wellness Centres will provide a platform for coordination and holding meetings with Zilla/ Block/
Gram Panchayat for planning avenues and strategies for health promotion related to various dimensions of
primary care. Such phase wise meetings will also support in planning health education and communication
strategies.
For effective delivery of services and health promotion, coordination activities should be strengthened
between frontline workers of various programmes/institutions such as MGNREGA, ICDS, NRLM, Panchayati
Raj and VHSNCs, e.g., a house wise nutritional plan consisting of recommended dietary allowance of each
family should be prepared and monitored by the HWC team. Kitchen gardens to cover monthly requirement
of balanced diet should be encouraged.
In Urban areas, the implementation of the components of UHWCs involves mapping the vulnerable
population for which a close collaboration with ULBs would be instrumental in planning the location of
the facilities in the vulnerable areas. Engaging Urban Local Bodies (ULB) in MAS would ensure planning and
monitoring of health services through community participation and strengthen outreach, preventive and
promotive functions including public health actions at UHWC.
The support of ULBs can be leveraged for formation of Resident Health Associations, a platform or federation
of representatives of MAS (from poorer areas), Resident Welfare Association (RWA) such as Gully/Mohalla
committees. The ULBs can mobilize the Residential Welfare Associations (RWAs) to undertake public health
activities including health promotion activities about clean environments, lifestyle changes, healthy diets,
etc. and also spread awareness on the diseases prevalent in the community viz seasonal, infectious etc.
Community linkages with existing SHGs and Galli/Mohalla committees may also be utilized for the purpose.
In addition to above, engagement with private and not for profit sector for critical gap filling activities for
UHWCs, such as capacity building, UHWCs management, provision of outreach services, diagnostic services,
as appropriate to the local context, need and availability of the organizations to provide services etc. may
be explored.
Annexures
ANNEXURE 1
Citizens’ Charter
Annexures | 35
Annexure 2
Service Delivery Framework
S. No. Health Care Services Care at Community Level Care at the Health and Wellness Care at the referral site** (PHC and
Centres-Sub Health Centres/ Urban upwards)
Health and Wellness Centres
1. Care in pregnancy and childbirth yy Early diagnosis of pregnancy yy Early registration of pregnancy and yy Antenatal and postnatal care of
issuing ID number and Mother and high-risk cases
yy Ensuring four antenatal care
Child Protection (MCP) card.
checks yy Blood grouping and Rh typing
yy Antenatal check-up including and blood cross matching
yy Counselling regarding care
screening for Hypertension,
during pregnancy including yy Linkage with nearest ICTC/PPTCT
Diabetes, Anemia. Immunization
information about nutritional Centre for voluntary testing for
for pregnant women-Td, IFA and
requirements HIV and PPTCT services
Calcium supplementation
yy Identifying of high-risk yy Normal vaginal delivery and
yy Identifying high risk pregnancies,
pregnancies and follow up assisted vaginal delivery
postpartum cases for regular
yy Enabling access to Take home follow up, timely referral for yy Surgical interventions like
ration from Anganwadi Centre institutional births and complication Caesarean section,
management.
yy Follow up to ensure compliance yy Management of all complications
to IFA in normal and anemic yy Screening, referral and follow including ante- partum and post-
cases up care in cases of Gestational partum haemorrhage, eclampsia,
Diabetes, and Syphilis during puerperal sepsis, obstructed
yy Facilitating institutional delivery pregnancy labour, retained placenta, shock,
and supporting birth planning
severe anaemia, breast abscess.
yy Normal Vaginal delivery in specified
yy Post- partum care visits delivery sites as per state context yy Blood transfusion facilities
yy Identifying high risk pregnancies, -where CHO or MPW (F) is trained as
child births and post-partum skill birth attendant.
cases and facilitating timely yy Provide first aid treatment and
referrals referral for obstetric emergencies,
e.g., eclampsia, PPH, Sepsis, and
prompt referral.
2. Neonatal and infant Health yy Home based new-born care yy Identification and management yy Care for low-birth-weight new-
through 7 visits in case of home of high-risk new-born – low birth borns (<2500gms)
delivery and 6 visits in case of weight/preterm/ sick new-born and
yy Treatment of asphyxia and
institutional delivery sepsis (with referral as required),
neonatal sepsis,
yy Identification and care of high- yy Management of birth asphyxia yy Treatment of severe ARI and
risk new-born – low birth weight/ Diarrhoea/Dehydration cases
yy Identification, appropriate referral
preterm new- born and sick new-
and follow up of congenital yy Vitamin K for premature babies
born (with referral as required),
anomalies
yy Counselling and support for yy Management of all emergency
early breast feeding, improved yy Management of ARI/Diarrhoea and and complication cases.
weaning practices. other common illness and referral of
severe cases.
yy Iron supplementation
yy Screening, referral and follow up
yy Adoption of safe and hygiene
for disabilities and developmental
WASH practices
delays
yy Growth Monitoring
yy Complete immunization
yy Counselling for Early childhood
growth and Development. yy Vitamin A supplementation
yy Identification of birth asphyxia, yy Identification and follow up, referral
sepsis and referral after initial and reporting of Adverse Events
management Following Immunization (AEFI).
yy Identification of congenital
anomalies and appropriate
referral
yy Family /community education
for ‘prevention of infections and
keeping the baby warm
yy Identification of ARI/Diarrhoea-
identification, initiation of
treatment- ORS and timely
referral as required
yy Mobilization and follow up for
immunization services
3. Childhood and Adolescent health yy Growth Monitoring, IYCF yy Complete immunization yy NRC Services
care services including immunization continued and enable access to
yy Detection and treatment of yy Management of SAM children,
food supplementation- all linked
Anaemia and other deficiencies in severe anaemia or persistent
to ICDS
children and adolescents malnutrition
yy Detection of SAM, referral and
yy Severe Diarrhoea and ARI
follow up care for SAM
management
Annexures | 37
yy Prevention of Anaemia, yy Identification and management yy Management of all ear, eye and
iron supplementation and of vaccine preventable diseases throat problems, skin infections,
deworming in children such as Diphtheria, worm infestations, febrile seizure,
Pertussis and Measles poisoning, injuries/accidents,
yy Prevention of diarrhoea/
insect and animal bites
ARI, prompt and appropriate yy Early detection of growth
treatment of diarrhoea/ ARI with abnormalities, delays in yy Diagnosis and treatment for
referral where needed development and disability and disability, deficiencies and
referral development delays
yy Pre-school and School Child
Health: Biannual Screening, yy Prompt Management of ARI, acute yy Surgeries for any congenital
School Health Records, Eye care, diarrhoea and fever with referral as anomalies like cleft lips and cleft
De-worming needed palates, club foot etc.
yy Screening of children under yy Management (with timely referral Adolescent Health
national program to cover 4’D’s as needed) of ear, eye and throat
Viz. Defect at birth, Deficiencies, problems, skin infections, worm yy Screening for hormonal
Diseases, Development delay infestations, febrile seizure, imbalances and treatment with
including disability poisoning, injuries/accidents, insect referral if required
and animal bites yy Management of growth
Adolescent Health
abnormality and disabilities, with
Adolescent Health
Counselling on- referral as required
yy Detection of SAM, referral and
Improving nutrition yy Management including
follow up care for SAM.
rehabilitation and counselling
yy Sexual and reproductive health yy Adolescent health- counselling services in cases of substance
yy Enhancing mental health / abuse
yy Detection for cases of substance
Promoting favourable attitudes abuse, referral and follow up yy Counselling at Adolescent
for preventing injuries and Friendly Health Clinics (AFHC)
violence Prevent substance yy Detection and Treatment of
misuse Anaemia and other deficiencies in
adolescents
yy Promote healthy lifestyle
yy Detection and referral for growth
yy Personal hygiene- Oral Hygiene abnormality and disabilities, with
and Menstrual hygiene referral as required
yy Peer counselling and Life skills
education
yy Prevention of anaemia,
identification and management,
with referral if needed
yy Provision of IFA under
National Program for Iron
Supplementation
4. Family planning, contraceptive yy Counselling for creating yy Insertion of IUCD yy Insertion of IUCD and Post-
services and other reproductive care awareness against early marriage Partum IUCD
yy Removal of IUCD
services and delaying early pregnancy
yy Removal of IUCD
yy Provision of condoms, oral
yy Identification and registration of
contraceptive pills and emergency yy Male sterilization including Non-
eligible couples
contraceptive pills scalpel Vasectomy
yy Motivating for family planning
yy Provision of Injectable yy Female sterilization (Mini- Lap
(Delaying first child and spacing
Contraceptives in MPV districts and Laparoscopic Tubectomy)
between 2 children)
yy Counselling and facilitation for safe yy Management of all complications
yy Provision of condom, oral
abortion services
contraceptive pills and yy Provision of Injectable
emergency contraceptive pills yy Medical methods of abortion (up to Contraceptives
7 weeks of pregnancy) on fix days at
yy Follow up with contraceptive yy Medical methods of abortion (up
the HWC by PHC MO
users to 7 weeks of pregnancy) with
yy Post abortion contraceptive referral linkages MVA up to 8
yy Other reproductive care services
counselling weeks
yy Counselling and facilitation of
yy Follow up for any complication after yy Referral linkages with higher
safe abortion services
abortion and appropriate referral if centre for cases beyond 8 weeks
yy Post abortion contraceptive needed of pregnancy up to 20 weeks
counselling
yy First aid for GBV related injuries yy Treatment of incomplete/
yy Follow up for any complication – link to referral centre and legal Inevitable/ Spontaneous
after abortion and appropriate support centre Abortions
referral if needed
yy Identification and management of yy Second trimester MTP as per MTP
yy Education and mobilizing RTIs/STIs Act and Guidelines
of community for action on
yy Identification, management (with yy Management of all post abortion
violence against women
referral as needed) in cases of complications
yy Counselling on prevention of RTI/ dysmenorrhea, vaginal discharge,
yy Management of survivors of
STI mastitis, breast lump, pelvic pain,
sexual violence as per medico
pelvic organ prolapse
yy Identification and referral of RTI/ legal protocols.
STI cases
yy Management of GBV related
yy Follow up and support PLHA injuries and facilitating linkage to
(People Living with HIV/AIDS) legal support centre
groups
yy Ensure regular treatment and
follow of diagnosed cases
Annexures | 39
yy Management of hormonal and
menstrual disorders and cases of
dysmenorrhea, vaginal discharge,
mastitis, breast lump, pelvic pain,
pelvic organ prolapse
yy Provision of diagnostic tests
services such as (VDRL, HIV)
yy Management of RTIs/STIs
yy PPTCT at district level
5. Management of Communicable yy Symptomatic care for fevers, URIs, yy Identification and management of yy Diagnosis and management
diseases and General Outpatient care LRIs, body aches and headaches, common fevers, ARIs, diarrhoea, of all complicated cases
for acute simple illness and minor with referral as needed and skin infections. (Scabies and (requiring admission) of fevers,
ailments abscess) gastroenteritis, skin infections,
yy Identify and refer in case of skin
typhoid, rabies, helminthiasis,
infections and abscesses yy Identification and management
patitis acute
(with referral as needed) in cases
yy Preventive action and primary
of cholera, dysentery, typhoid, yy Specialist consultation for
care for waterborne disease,
hepatitis and helminthiasis diagnostics and management of
like diarrhoea, (cholera, other
Musculoskeletal disorders, e.g.-
enteritis) and dysentery, typhoid, yy Management of common aches,
arthritis.
hepatitis (A and E) joint pains, and common skin
conditions, (rash/urticaria)
yy Creating awareness about
prevention, early identification
and referral in cases of
helminthiasis and rabies
yy Preventive and promotive
measures to address
Musculoskeletal disorders-
mainly osteoporosis, arthritis and
referral or follow up as indicated
yy Providing symptomatic care for
aches and pains – joint pain, back
pain etc
6. Management of Communicable yy Community awareness for yy Diagnosis, (or sample collection) yy Confirmatory diagnosis and
diseases: National Health prevention and control measures treatment (as appropriate for that initiation of treatment
Programmes (Tuberculosis, Leprosy, level of care) and follow up
yy Management of Complications,
Hepatitis, HIV-AIDS, Malaria, Kala-
azar, Filariasis and Other vector borne
diseases)
yy Screening, Identification, prompt care for vector borne diseases – yy Rehabilitative surgery in case of
presumptive treatment initiation Malaria, Dengue, Chikungunya, leprosy
and referral as appropriate and Filaria, Kala Azar, Japanese
specified for that level of care Encephalitis, TB and Leprosy
yy Ensure compliance with follow yy Provision of DOTS for TB and MDT
up medication compliance for leprosy
yy Mass drug administration in yy HIV screening, appropriate referral
case of filariasis and facilitate and support for HIV treatment.
immunization for Japanese
encephalitis yy Referral of complicated cases
yy Collection of blood slides in

case of fever outbreak in malaria
prone areas
yy Provision of DOTS/ensuring
treatment adherence as per
protocols in cases of TB
7. Prevention, Screening and yy Population empanelment, yy Screening and treatment yy Diagnosis, treatment and
Management of Non-Communicable support screening for universal compliance for Hypertension and management of complications of
diseases screening for population – Diabetes, with referral if needed Hypertension and Diabetes
age 30 years and above for
yy Screening and follow up care yy Diagnosis, treatment and follow
Hypertension, Diabetes, and
for occupational diseases up of cancers (esp. Cervical,
three common cancers – Oral,
(Pneumoconiosis, dermatitis, lead Breast, Oral)
Breast and Cervical Cancer
poisoning); fluorosis; respiratory
yy Diagnosis and management of
yy Health promotion activities – to disorders (COPD and asthma) and
occupational diseases such as
promote healthy lifestyle and epilepsy
Silicosis, Fluorosis and respiratory
address risk factors
yy Cancer – screening for oral, breast disorders (COPD and asthma)
yy Early detection and referral for and cervical cancer and referral for and epilepsy
– Respiratory disorders – COPD, suspected cases of other cancers
Epilepsy, Cancer, Diabetes,
yy Confirmation and referral for
Hypertension and occupational
deaddiction – tobacco/ alcohol/
diseases (Pneumoconiosis,
substance abuse
dermatitis, lead poisoning) and
Fluorosis yy Treatment compliance and follow
up for all diagnosed cases
yy Mobilization activities at village
level and schools for primary and yy Linking with specialists and
secondary prevention undertaking two-way referral for
Annexures | 41
complication
yy Treatment compliance and follow
up for positive cases
8. Screening and Basic management of yy Healthy life style tips- yy Awareness and stigma reduction yy Awareness and stigma reduction
Mental health ailments balanced diet, exercise, stress activities at individual level & activities at individual level
management. psychoeducation for all groups of
yy Diagnosis and Treatment of
MNG conditions
yy Screening using CIDT tool for mental illness
mental illness yy Promotion of mental health through
yy Suicide risk assessment, suicide
family enrichment programme
yy Community awareness about management, referral, follow up
mental disorders (Psychosis, yy Detection and referral of patients and emergency management of
Depression, Neurosis, Dementia, with severe mental disorders poisoning
Mental Retardation, Autism,
yy Confirmation and referral to yy Emergency care for seizures
Epilepsy and Substance Abuse
deaddiction Centres
related disorders) yy Provision of out -patient and in-
yy Dispense follow up medication as patient services
yy Patient Health Questionnaires 2
prescribed by the Medical Officer at
to be included in CBAC form. yy Counselling services to patients
PHC/ CHC or by the Psychiatrist at
(and family if available)
yy Identification and referral to the DH.
HWC/ PHC for diagnosis
yy Counselling and follow up of
yy Ensure treatment compliance patients with Severe Mental
and follow up of patients with Disorders
Severe Mental Disorders
yy Suicide risk assessment, suicide
yy Support home-based care by management by gatekeepers,
regular home visits to patients of referrals, and follow-up for suicidal
Severe Mental Disorders ideation and behaviour.
yy Facilitate access to support yy Formulation of comprehensive plan
groups, day care centres and for persons with Dementia.
higher education/ vocational
yy Establish linkages with NGOs,
skills
Government departments,
PRIs, ULBs to facilitate access to
entitlements and referral linkages
with faith healers and referral and
integrated coordination with other
programmes.
yy Management of Violence related
concerns
9. Care for Common Ophthalmic and yy Community based services, yy Awareness about common yy Advocacy for ENT services.
ENT problems Counselling and support for care ophthalmic & ENT problems and
yy Management of all Acute and
seeking for blindness, other eye illness through IEC
chronic eyes, ear, nose and throat
and ENT disorders
yy Screening for visual acuity, problems
yy Health Promotion through blindness, cataract and for refractive
yy Surgical care for ear, nose, throat
appropriate IEC with special errors
and eye
emphasis on prevention of
yy Identification and treatment
ophthalmic and ENT problems. yy Management of Cataract,
of common eye problems –
Glaucoma, Diabetic retinopathy
yy Community screening for conjunctivitis, acute red eye,
and Corneal ulcers and of referral
congenital disorders and referral trachoma; spring catarrh,
cases from HWC-SHCs/UHWCs.
and early identification of ENT xeropthalmia as per the STG
related problems like sign of yy Diagnosis and management of
yy Management of common colds,
hearing loss in infants, children blindness, hearing and speech
Acute Suppurative Otitis Media,
and adults. impairment
injuries, pharyngitis, laryngitis,
yy Screening for blindness and rhinitis, URI, sinusitis, epistaxis yy Management including nasal
refractive errors and ENT packing, tracheostomy, foreign
yy Early detection of hearing
problems body removal etc.
impairment and deafness with
yy AWC based screening for children referral yy Offering support services to
from 6 to 18 year through RBSK. hearing aid users e.g., day to day
yy Diagnosis and treatment services for
care such as change of batteries,
yy Recognizing and treating acute common diseases like otomycosis,
Do’s & Don’ts while handling the
suppurative otitis media and otitis externa, ear discharge etc.
aid etc.
other common ENT problems
yy First aid for injuries/ stabilization
yy Counselling and referral of
and then referral.
patients with complications and
yy Removal of Foreign Body. (Eye, Ear, which require surgical treatment.
Nose and throat)
yy Identification and referral of thyroid
swelling, discharging ear, blocked
nose, hoarseness and dysphagia
10. Basic oral health care yy Providing awareness about oral yy Providing awareness about oral yy Providing awareness to OPD
health & hygiene, and health care health & hygiene, and health care patients about oral health &
seeking practices through IEC seeking practices through IEC and hygiene, and health care seeking
and planned interactive sessions planned interactive sessions. practices through IEC and
in home visits, community planned interactive sessions
meetings of the VHSNC, MAS and Diagnosis and management of
VHNDS/UHNDs and nutritional oral cancer
Annexures | 43
days in rural and urban area.
yy Create awareness, early detection yy Screening and early identification yy Monitoring and ensuring quality
and referral for fluorosis, and of common dental problems care and smooth functioning of
other common oral problems like like gingivitis, periodontitis, oral health services at HWCs.
caries, gingivitis and tooth loss malocclusion, dental caries, dental
yy Record keeping and
etc. fluorosis and oral cancers, with
maintenance of registries.
referral
yy Creating awareness about ill
yy Conduct various Oral Health
effects of Substance Abuse like yy Oral health education about
Care training programs to
tobacco, beetle and areca nut, dental caries, periodontal diseases,
schoolteachers, volunteers and
smoking, reverse smoking and malocclusion and oral cancers
other Self- Help Groups.
alcohol
yy Co-ordinate various Oral Health
yy Co-ordinate various Oral Health Care training programs to school Assured Services: -
Care training programs to school teachers, volunteers and other yy Management of malocclusion,
teachers, volunteers and other self- Help groups for imparting trauma cases, Tooth abscess,
self- Help groups for imparting preventive and promotive oral caries
preventive and promotive oral health education.
health education. yy Topical application of fluoride for
yy Management of conditions like caries prevention.
yy Participate and coordinate the apthous ulcers, candidiasis and
outreach activities. glossitis, with referral for underlying
disease
yy Symptomatic care for tooth ache
and first aid for tooth trauma, yy Participate and coordinate the
with referrals outreach activities of PHC.
yy Mobilization for screening of oral yy Symptomatic care for tooth ache
cancer on screening day and first aid for tooth trauma, with
referral
yy Counselling for tobacco cessation
and referral to Tobacco Cessation
Centres.
yy Maintain records of all the identified
oral diseases reporting in the OPD in
a standardized recording format.
11. Elderly and palliative health care yy Identification of high-risk groups yy Home based care must be yy Provide awareness by sensitizing
service supported by a home visit by health care givers, on prevention of fall,
yy Support to family in palliative
care professional trained in palliative malnutrition and neglect of care,
care
care and by linkages to day-to-day social security schemes, social
yy Home visits for care to home Centres and hospices to manage entitlements etc.
bound/ bedridden elderly, situations that are difficult to handle
disabled elderly persons at home.
yy Support family in identifying yy The CHO will be provided with a yy OPD: Diagnosis, treatment and
behavioral changes in elderly “Palliative- Care Kit”. referral for complications.
and providing care
yy Arrange for suitable supportive yy Drugs & Consumables: -Essential
yy Linkage with other support devices from higher Centres to the Drugs including Narcotics should
groups and day care Centres etc. elderly /disabled persons to make be made available at PHC level.
operational in the area. them ambulatory.
yy Home care and End or Life Care.
yy Community mobilization on yy Palliative care team should provide
yy Referral for those requiring
promotional, preventive and out of hours care to those who
secondary level of palliative care.
rehabilitative aspects of elderly. require end of life care.
yy Rehabilitation through
yy Community awareness on yy Referral for diseases needing further
physiotherapy and counselling
various social security schemes investigation and treatment, to
for elderly PHC/CHC/DH yy Identify care givers and empower
them to take care of bed bound
yy Identify and report elderly yy CHOs to undertake Comprehensive
elderly.
abuse cases, and provide family Geriatric Assessment twice in a
counselling year for cognitive decline, limited yy Ensure continuous psychosocial
mobility, malnutrition, visual support to family members and
impairment, hearing loss, and other informal care givers of care
depressive symptoms. dependent elderly patients.
yy Develop elderly self-help groups yy Impart training to care givers.
named Sanjeevani & ensure
involvement of active and mobile yy Provide dietary advice like oral
elderly in various activities like supplemental nutrition etc. for
awareness generation, assessment undernourished elderly.
of fit elders. yy Advanced Comprehensive
yy Undertake monthly visit to Geriatric Assessment.
bedbound elderly. yy Provision of diagnostics,
yy Ensure mobile elderly & restricted equipment, consumables,
mobile elderly attend yoga/activity medicines and services for
sessions at HWCs. Elderly leveraging other National
Health Programmes.
yy Promote healthy behaviors.
yy Referral of elderly patients
yy Promote inter-generational bonding requiring secondary & tertiary
and involvement of elderly, ASHA care to higher Centre.
& MPW to identify volunteers from
youth groups.
Annexures | 45
yy Management of common geriatric
ailments; counselling, supportive
treatment
yy Pain Management and provision of
palliative care with support of ASHA.
yy VHSNCs/JAS/MAS/RWA will
ensure availability of benefits from
various governments and non-
governmental programs/schemes to
the eligible patients/caregivers.
12. Emergency Medical Services, yy Providing awareness to the yy Providing awareness to the yy Triage and management of
including for Trauma and Burns community for handling community for handling trauma cases
emergencies in health. emergencies in health.
yy Management of poisoning,
yy First aid for trauma including yy Stabilization care with Triaging
yy Management of simple fractures
management of minor injuries, based on ABCD criteria and first
and poly trauma
fractures, animal bites and aid before referral in cases of –
poisoning poisoning, trauma, minor injury, yy Basic surgery and surgical
burns, respiratory arrest and cardiac emergencies (Hernia, Hydrocele,
arrest, fractures, shock, chocking, Appendicitis, Haemorrhoids,
fits, drowning, animal bites and Fistula, and stitching of injuries)
hemorrhage, infections (abscess etc.
and cellulitis), acute gastrointestinal
conditions and acute Genito urinary yy Handling of all emergencies like
condition animal bite, Congestive Heart
Failure, Left Ventricular Failure,
yy Identify and refer cases for surgical acute respiratory conditions,
correction – lumps and bumps burns, shock, acute dehydration
(cysts/ lipoma/ hemangioma/ etc.
ganglion); anorectal problems,
hemorrhoids, rectal prolapse,
hernia, hydrocele, varicocele,
epidymo-orchitis, lymphedema,
varicose veins, genital ulcers, bed
ulcers, lower urinary tract symptoms
(Phimosis, paraphimosis), and
atrophic vaginitis.
yy Facilitate referral and basic
management with communication
to higher Centre.
yy Administer Td if not immunized.
13. Linkages with Outreach Public Health yy The PRIs/ULBs and frontline yy Capacity building/sensitization/ yy To support HWCs in their
surveillance, VHNDs, UHND and workers shall be oriented on designated activities in public
yy orientation of community/PRIs/
special outreach. identification and reporting of health importance including
ULBs, frontline workers on public
any abnormal morbidity and emergency preparedness and
health issues, challenges and
mortality in human beings and disaster management plan.
importance of timely reporting.
animals.
yy Timely management of all the
yy Facilitate testing of samples and
yy VHNDs, UHNDs, AWCs and other referred cases.
timely submission of designated
community level facility platform
public health surveillance forms.
can be identified for organizing
VHND. yy Planning for emergency
preparedness and disaster
yy Community linkages with
management
existing SHGs and Galli/Mohalla
committees may also be utilized yy Capacity building of PRIs/ULBs/
for the purpose. frontline workers as first responders
during emergency.
yy The PRIs, ULBs and community
should be oriented to participate yy Screening of early childhood
in VHNDs and UHNDs for availing diseases, through an active School
specific services being organized. Health Programme.
yy While attending physical yy Identification of site for VHND/
distancing and infection UHND.
prevention protocols needs to be
adhered. yy Service delivery through VHND/
UHND as per the GoI guidelines.
yy Collaboration with Urban
Local bodies to strengthen the yy Need- based special outreach in
outreach and preventive and urban areas.
promotive functions including
public health actions and
surveillance.
14. Services to be given by MO at yy In addition to the above the
UHWCs. Medical Officer at UHWCs will
also manage the clinical cases by
proper diagnosis, treatment and
follow up of patients.
yy He/she will supervise all the
staff members working under
UHWC, guide them, monitor their
Annexures | 47
performance to ensure services
are available to the community
seamlessly.
ANNEXURE 3
Layout Plans
HWC-SHC without Labour Room and with Residential Facility
Annexures | 49
HWC-SHC without Labour Room and without Residential Facility
HWC-SHC with Labour Room and without Residential Facility
Annexures | 51
HWC-SHC with Labour Room and with Residential Facility
Annexures | 53
HWC-SHC New Construction
Annexures | 55
The Detailed layout plan for HWC- SHC can be accessed through the link provided:
https://nhsrcindia.org/IPHS2022
Annexure 4
Disaster Management & Preparedness
Fire safety Norms
Provisions laid down in National Building Code 2016 (4.5.2-subdivision C-1) are the minimum requirements
for a reasonable degree of safety from fire emergencies in hospitals, such that the probability of injury and
loss of life from the effects of fire are reduced. All healthcare facilities should be so designed, constructed,
maintained, and operated as to minimize the possibility of a Fire emergency requiring the evacuation of
occupants, as safety of hospital occupants cannot be assured adequately by depending on evacuation
alone. Hence measures shall be taken to limit the development and spread of a fire by providing appropriate
arrangements within the hospital through adequate staffing & careful development of operative and
maintenance procedures consisting of:
yy Design and Construction.
yy Provision of Detection, Alarm and Fire Extinguishment.
yy Fire Prevention
yy Planning and Training programs for Isolation of Fire; and
yy Transfer of occupants to a place of comparative safety or evacuation of the occupants to achieve
ultimate safety.
Expected Levels of Fire Safety in Hospitals
Hospitals shall provision for two levels of safety within their premises:
(1) Comparative Safety: which is protection against heat and smoke within the hospital premises,
where removal of the occupants outside the premises is not feasible and/or possible. Comparative
Safety may be achieved through:
(a) Compartmentation (b) Fire Resistant wall integrated in the Flooring (c) Fire Resistant Door of
approved rating (d) Corridor, Staircase (e) Pressurized Shaft or naturally ventilated stair balconies
(f ) Refuge Area (g) Independent Ventilation system(h) Fire Dampers (i) Automatic Sprinkler System
(j) Automatic Detection System(k) Manual Call Point(l) First Aid (m) Fire Fighting Appliances (n) Fire
Alarm System (o) Alternate Power Supply (p) Public Address System (q) Signage (r) Fire Exit Drills and
orders
(2) Ultimate Safety: which is the complete removal of the occupants from the affected area to an
assembly point outside the hospital building. Ultimate Safety may be achieved through:
(a) Compartmentation (b) Fire Resistant Door of approved rating (c) Corridor, Staircase and Shaft
(d) Public Address System (e) Signage (f ) Fire Drills and orders
Open space
yy Hospitals shall make provisions for sufficient open space in and around the hospital building to
facilitate the free movement of patients and emergency/fire vehicles.
yy These open spaces shall be kept free of obstructions and shall be motorable.
yy Adequate passageway & clearance for fire fighting vehicles to enter the hospital premises shall be
provided.
yy The width of such entrances shall not be less than 4.5 meters with clear head room not less than 5
meters.
Annexures | 57
yy The width of the access road shall be a minimum of 6 meters.
yy A turning radius of 9 meters shall be provided for fire tender movement.
yy The covering slab of storage/static water tank shall be able to withstand the total vehicular load of
45 tone equally divided as a four-point load (if the slab forms a part of path/driveway).
yy The open space around the building shall not be used for parking and/or any other purpose.
yy The Setback area shall be a minimum 4.5 meters.
yy The width of the main street on which the hospital building abuts shall not be less than 12 meters &
when one end of that street shall join another street, the street shall not be less than 12 meter wide.
yy The roads shall not be terminated in dead ends.
Instructions for Fire Safety for Hospital Staff Instructions for Personal Safety
All Hospital Staff should know:

yy The location of MOEFA push button fire alarm boxes. They should read the operating instructions.
yy Location of the fire extinguishers, hose reel, etc. provided on their respective floors.
yy The nearest exit from their work area.
yy The assembly point in emergencies.
Matters to be reported to the Fire Officer

yy If any exit door/route is obstructed by loose materials, goods, boxes, etc.
yy If any staircase door, lift lobby door does not close automatically, or does not close completely.
yy If any push button fire alarm point or fire extinguisher is obstructed, damaged or apparently out of
order.
Instructions for Fire Incidents
During any fire incident in the hospital premises, staff should:

yy Break the glass of the nearest fire alarm (if they are the first ones to discover the fire).
yy Attack the fire with fire extinguishers/hose reel provided on the floor.
Safe electricity
yy Two numbers of earthing should be there at each electrical installation. Copper plate earthing
should be preferred.
yy Provision of surge protection/suppressor should be there. Surge suppressors are rated according
to size of voltage spike they can handle, so only units of high enough joules rating to protect the
equipment should be used.
yy Load calculation should be proper, accordingly the distribution, electrical switchgear rating, circuitry,
cabling, and electrical installation should be there.
yy The size of cabling and wiring should be about 1.5 times or more to the actual electrical load
calculated.
yy Adequate powers back up with another source such as DG, Photovoltaic etc. should be there in
synchronization with the first source.
yy Some places which are very important, provision of uninterrupted power supply should be ensured.
yy Phase sequence should be proper as for motorized load.
yy Load monitoring should be there to avoid any overloading
yy A lot of motorized as well as semiconductor material devices are there hence provision of power
factor improvement should be there.
yy All the Connection and joint should be tight with proper size of thimbling.
yy Balancing of electrical load should be proper and monitored via measuring devices.
yy Suitable place should be selected for electrical installation.
yy Sensitive equipment should be provided with proper rating UPS for extra safety against disturbances
as voltage spike and noise.
yy The Electrical Switch Room shall be housed in a dedicated room/ cupboard located on the ground
floor and in association with an external wall and shall have internal access. The room shall be located
so that it does not present difficulties for services distribution from adjoining spaces or rooms, and
it shall be located to provide for economic distribution of services. The main switchboard shall be of
metal clad cubicle design to approved standards and regulations. Each switchgear assembly shall
have sufficient spare capacity. Electronic surge protection shall be provided on the incoming mains.
Earthquake Safety Provisions
All new hospital buildings or hospital buildings being retrofitted in seismic zone IV and V, and hospital
buildings in wind zones with basic wind speed 42 m/s or more, shall be instrumented with proper mechanism
prescribed in NBC.
Safer and functional Hospital: One of the main concerns regarding the safety of hospitals is that hospital
structures (i.e., the buildings) are themselves vulnerable to collapse in the face of extreme forces (such as
those experienced during earthquakes). Therefore, to ensure the safety of hospitals and achieve the goal
of ‘safer and functional hospitals’, mitigation measures (as presented in NBC) need to be undertaken in a
programmatic manner by the Ministry of Health and Family Welfare on an urgent basis.
Post-Earthquake Assessment of Hospital Structures

Hospital buildings shall be inspected by competent licensed engineers after every damaging earthquake to
document damages (if any) to Structural Element (SEs) and Non Structural Element (NSEs) of the buildings,
along with recommendations for detailed study and suitable retrofitting as found necessary.
Annexures | 59
Annexure 5
Roles & Responsibilities of HWC-SHC Staff
Community Health Officer (CHO)
The CHO would broadly be expected to carry out public health functions, ambulatory care, management
and provide leadership at the HWC-SHC. They would be responsible for the following:
1. Ensure that all households in the service area are listed, empaneled and a database is maintained- in
digital format/ paper format as required by the state.
2. Provide clinical care as specified in the care pathways and standard treatment guidelines for the range
of services expected of the SHC.
3. Clinical care provision would include coordinating for care/ case management for chronic illnesses
based on the diagnosis and treatment plan made by the Medical Officer/specialists who will initiate
treatment for chronic diseases, dispense drugs as per standing orders by the medical officer.
4. Such coordination could be facilitated through processes such as telehealth. However, CHOs can
also provide medicines as per the provisions of Schedule K, Item 23.
5. Focus attention in screening for chronic conditions on screening, enabling suspected cases confirmed
and initiating treatment based on appropriate STGs or on basis of plans made by medical officer/
specialists. As a team, ensure adherence, along with counselling and support as needed for primary
and secondary prevention efforts. Such chronic conditions would include both non -communicable
diseases and the chronic communicable diseases of tuberculosis, leprosy and HIV.
6. Coordinate and lead local response to diseases outbreaks, emergencies and disaster situations and
support the medical team or joint investigation teams for disease outbreaks.
7. Support the team of MPWs and ASHAs in their tasks, including on the job mentoring, support and
supervision and undertaking the monitoring, management, reporting and administrative functions
of the HWC such as inventory management, upkeep and maintenance, and management of untied
funds.
8. Support and supervise the collection of population-based data by frontline workers, collate and
analyse data for planning and reporting of data to the next level in an accurate and timely fashion.
Use HWC and population data to understand key causes of mortality, morbidity in the community
and work with the team to develop a local action plan with measurable targets, including a particular
focus on vulnerable communities.
9. Coordinate with community platforms such as the VHSNC/MAS/SHGs and work closely with PRI/
ULB, to address social determinants of health and promote behaviour change for improved health
outcomes.
10. Address issues of social and environmental determinants of health with extension workers of other
departments related to gender-based violence, education, safe potable water, sanitation, safe
collection of refuse, proper disposal of wastewater, indoor air pollution, and specific environmental
hazards such as fluorosis, silicosis, arsenic contamination, etc.
Medical Officer (MO) of UHWC

1. Clinical Work
yy The Medical Officer will be organizing and performing duties necessary for the routine Outpatient
services and also ensure emergency cases are attended and taken care of.
yy He/she will screen cases needing specialized medical attention, refer them to referral institutions
and will cooperate and coordinate with other institutions providing medical care services in his/
her area.
yy He/ she will attend all calls from the in-patients, while he/ she is ‘on-call duty’
yy As a member of the health care team, he/she will exemplify an example in attitude toward
patients and staff, thereby, performing duties with respect, dignity, privacy, and modesty to the
patients.
yy He/ she will be friendly, courteous and sympathetic while working with patients and ensure
privacy and confidentiality of the patients.
yy He/she will perform any other duties which a Medical Officer is expected to perform in view of
his position and any other duties which will be assigned as and when required.
2. Public Health Work
yy He/she will make arrangements and provide guidance for rendering health care services at the
community level and at the PHC through the Health Assistants, Health Workers and others.
yy The Medical Officer will ensure that all the members of his/her Health Team are fully conversant
with the various National Health & Family Welfare Programs including NHM to be implemented
in the area allotted to each Health functionary.
yy He/she will prepare operational plans and ensure effective implementation of the same to
achieve the laid down targets under different National Health and Family Welfare Programmes.
yy Any services, speciality or otherwise, being rendered in the hospital, its quality delivery and
other necessary coordination will be ensured by the MO
yy The MO will ensure the effective implementation of all National Health Programmes –
Reproductive and Child Health Programme, Universal Immunization Programme, National
Vector Borne Disease Control Programme, National Programme for control of Blindness,
Non-Communicable Diseases Programmes, National Mental Health Programme, Control of
Communicable Diseases, Leprosy, Tuberculosis, Sexually Transmitted Diseases and Ayushman
Bharat
yy He/she will be responsible for proper and successful implementation of the Programmes in PHC
area, including education, motivation, delivery of services and aftercare.
yy He/she will be responsible for all administrative and technical matters regarding the operations
of National Health Programmes in his/her UHWC area.
yy He/she will be responsible for all Health Education activities in his/her area.
yy He/she will take the necessary steps for institutionalizing public health surveillance and
undertake timely actions in case of any outbreak of epidemic in his/her area.
3. Administrative Work
yy He/she will supervise the work, scrutinize the programmes of his/her staff and suggest changes
if necessary to suit the priority of work of staff working under him/her.
yy He/she will hold monthly staff meetings to evaluate the progress of work and suggest steps to
be taken for further improvements
yy He/she will ensure the maintenance of the prescribed records and registers at UHWC level and
will issue various kinds of certificates in the capacity of a medical officer.
yy He/she will ensure that the problems and grievances of the staff are solved promptly.
yy He/she will ensure the confidentiality of the patients
yy He/she will take actions timely for legal matters, medico-legal cases, RTIs, court cases and
expeditions implementation of orders of the courts.
yy He/she will organize training programmes including continuing education for the staff of PHC
and ASHA under the guidance of the district health authorities and Health & Family Welfare
Annexures | 61
Training Centres and will ensure that the staff working under his office regularly gets appropriate
training.
yy He/she will assess the performance of the staff and arrange for retraining if required.
yy He/she will ensure appropriate utilization of funds as per the guidelines and GFR (General
Financial Rules) provisions.
yy He/she will ensure auditing procedures are completed well in advance, and audit reports are
furnished to all the concerned authorities.
yy He/she will dispose of all of the obsolete / condemned items and vehicles as per the Government
orders in force.
yy He/she will monitor and guide the activities of Hospitals/ UHWCs committees, patient welfare
societies of hospitals, village health & sanitation committees.
yy He/she will ensure inter-sectoral/ inter- departmental coordination; involvement of community
leaders, various social welfare agencies and people for effective provision of patient centric
healthcare.
yy He/ She will be involved in ‘performance audit’ of staff as per the guidelines of ‘Performance
Audit’.
yy He/ She will facilitate, coordinate, supervise, monitor and implement the provisions of all the
health sector Acts and the Rules.
Staff Nurses of UHWC

1. Clinical Work
yy S/he will assess the needs of the patients in the ward, explain the medicines to be taken, make a
nursing care plan for all patients consulting with ward sister.
yy S/he will give direct patient care and allotted responsibility to her/him by the ward sister.
yy S/he will provide comfort to the patient and maintain the safety of the patient (universal safety
precaution).
yy S/he will be friendly, courteous, and sympathetic while working with patients and ensure privacy
and confidentiality of the patients.
yy S/he will carry out procedures of admission, discharge and transfer of patient of the ward.
yy S/he will take care that discharged patients have a proper understanding of the follow-up
procedures and details of the diet, medication, exercise, etc.
yy S/he will be responsible for taking a history of the patient.
yy S/he will prepare and assist in the diagnostic procedure in the ward.
yy S/he will provide minor dressing in an emergency.
yy S/he will administer drugs by injection upon written order of the Doctor.
yy S/he will learn the handling of special gadgets & equipment.
yy S/he will distribute diet, milk, etc.
yy S/he will maintain a duty room in readiness for all time.
yy S/he will be responsible for observation of the patient’s condition, take prompt action and report
to the concerned medical officer.
yy S/he will give health education to the patients and their family members under care.
yy S/he will make records of all procedures of her/his patients and keep them up to date.
yy S/he will take care that case papers are not allowed to be handled by anyone except the doctor-
in-charge of the patient. This is specifically for medico-legal cases.
yy S/he will provide assistance and instructions to the patients and their relatives.
yy S/he will be responsible -To provide antenatal, intra-natal, postnatal care as taught in the nursing
curriculum.
yy S/he will perform any other duties which a Staff Nurse is expected to perform in view of his
position and any other duties which will be assigned as and when required.
2. Administrative work
yy S/he will ensure that all articles are sterilized, all equipment, gadgets, electrical connections,
light, fan etc. are maintained.
yy S/he will ensure that the specimens are collected, labelled and dispatched.
yy S/he will ensure to escort the patient to and from the department.
yy S/he will ensure that the reports are received and given to the patients as well as the doctor is
informed.
yy S/he will ensure that the patient’s problems are listened to and help them to solve them through
various means.
yy S/he will ensure the confidentiality of the patients.
yy S/he will ensure that the cultural and religious differences of the patients are respected.
yy S/he will supervise the students and ancillary staffs.
yy S/he will ensure that all records, outcome indicators as per LaQshya guidelines are maintained.
yy S/he will ensure to make the ward clean and tidy, including the bed.
yy S/he will keep all articles well-arranged and maintain the inventory.
yy S/he will maintain all records and mandates.
yy S/he will assist the ward sister in orientation programme of new staff and students and in the
supervision of work of Group D allotted in the ward for maintenance of cleanliness and sanitation.
yy S/he will accompany with doctors and senior nursing officers during ‘ward round’.
yy S/he will help ward sister in indenting and checking of drugs, supplies and maintaining
inventories.
yy S/he will perform the functions of the ward sister during her/his absence
yy S/he will assist in orientation of new staff nurses.
yy S/he will support and guide the ASHAs working in the HWC area.
yy S/he will participate in staff education and staff meeting.
yy S/he will maintain good interpersonal relations with all other staff.
yy S/he will give information about MLC cases to Head / Officer in charge.
yy S/he will co-operate in activities related to the National Health Programmes.
yy S/he will ensure safe disposal of biomedical waste.
yy S/he will keep herself/himself up to date with nursing knowledge by taking part in in-service
education programmes.
yy S/he will perform any other duty that may be assigned to her/him from time to time including
field work.
Annexures | 63
Multi-Purpose Worker-Female (MPW-F) /Auxiliary Nurse Mid Wife (ANM) of HWC-SHC
1. Clinical Work
A. Under the supervision of CHO, the MPW-F/ANM to perform the following functions:
yy General OPD services and managing cases at HWC-SHC
yy Early registration of pregnancy: issuing of ID number and Mother and Child protection
card
yy Antenatal check-up and identifying high risk pregnancies, child births and post-partum
cases.
yy Screening, referral of suspected cases and follow up care in case of gestational diabetes
and syphilis during pregnancy, STI/RTI, eye, ENT, TB, leprosy, non-communicable diseases,
vector borne diseases, common mental conditions, substance use and Epilepsy cases,
delays in development and disability and other congenital anomalies.
yy Identification and support in management of anaemia, nutritional deficiencies, and vaccine
preventable diseases in children and their complete immunization including identification
and follow up, referral and reporting of Adverse Events Following Immunization (AEFI)
yy Undertake Diagnostic Services- Pregnancy Test, Haemoglobin, Urine Test, Blood Sugar,
and other point of care diagnostic services specified for different service packages.
yy Provide first aid treatment for obstetric emergencies, e.g., eclampsia, PPH, Sepsis and
prompt referral (Type B SHC) and supporting medical team for handling other emergency
situations by coordinating
yy Midwifery Services in Sub Centres only where institutional deliveries have been allowed
by the state governments and provide appropriate treatment or refer to higher centres in
cases where ASHA is not able to manage with home-based care.
yy Reviewing completed CBAC for cancer symptoms/epilepsy/COPD and refers as appropriate.
yy Ensuring patient’s compliance for treatment.
A. Undertake household survey with ASHAs for detailed mapping, enumeration and enrolment of
population being covered in HWC and in urban areas where ASHAs are currently not available,
to identifying population at risk, estimating RCH needs etc.
B. Counselling and Health Education to the community on:
yy Danger signs during pregnancy, and teaching them importance of institutional delivery,
early and exclusive breastfeeding, seeking postnatal care, weaning and complementary
feeding, consuming nutritious diet and where to go for delivery.
yy Importance of complementary feeding, its components, on consuming supplementary
nutrition at AWCs and consuming iron-rich diet in children to avoid anaemia.
yy Childhood and adolescent healthcare services including nutrition, personal hygiene,
sanitation, menstrual hygiene management, healthy living etc. in the community through
home visits and through VHSNDs.
yy Family Planning/Education of children/Dangers of sex selection/Age at marriage/
Information on/Disease outbreak/Disaster management/Adolescent Health.
yy Care during communicable and vector-borne disease infections.
yy Lifestyle modifications needed for non-communicable diseases like Hypertension and
Diabetes and importance of regular follow up visits to Health and Wellness Centre or other
facilities for NCDs and ensuring adherence to treatment plans.
yy Oral Health education especially to antenatal and lactating mothers, school children and
adolescent, first aid and referral of cases with oral problems.
yy Motivation for quitting and referrals to Tobacco Cassation Centre at District Hospital/Medical
College.
yy Activities for prevention and early detection of hearing impairment/deafness, visual
impairments at the level of health facility, community and schools.
yy Sensitization of community regarding entitlements provided by government under various
national programs
3. Field/Home visits
yy Prioritize visit to pregnant women who did not attend their regular ANCs in the monthly ANC
clinics/ VHSND, bring them back to the system -motivate them for institutional deliveries.
yy Visits to postpartum mothers for home-based services and providing care - either as indicated by
ASHA after a home visit, or if ASHA is not there, or if they failed to attend VHSND.
yy Identify children who missed their immunization sessions and ensure that they get vaccinated
during next immunization session/campaigns.
yy Visit sick new-born/low-birth weight babies and children who need referral but are unable to
go, as indicated by ASHA and malnourished children who did not go for the medical reference -
ensure they get care at a higher centre.
yy Motivate Families with whom ASHA is having difficulty in motivating for changing health-seeking
behavior, adopting family planning methods and who did not come to VHSND.
yy Patients having chronic illnesses, who have not reported for follow up at the sub centre or VHSND
and encourage them to attend special-day clinics
yy Prioritized visits in areas where Fever Treatment Depots/ASHAs have not been deployed -
Collecting blood smears or performs RDTs from suspected malaria cases during domiciliary visits
and maintains records. Providing treatment to positive cases.
yy Distribution and utilization of LLIN Bed Nets; facilitate and ensure quality spray in households
and insecticide treatment of community-owned bed nets.
yy Verbal autopsy and/or at least preliminary inquiry into any maternal or child death.
yy Surveillance for unusually high incidence of cases of any communicable disease and notify CHO
and PHC-MO.
yy Ensuring regular testing of salt at household level for presence of Iodine through Salt Testing Kits
by ASHAs.
A. In ensuring that the untied funds are utilized as per the rules and guidelines.
B. Supportive and Supervisory function to ASHA in:
yy Replenishment of drugs in her kit.
yy Survey in the community for nutritional deficiency among those who had experienced trauma/
disaster/disease outbreak and spreading awareness on nutrition, lifestyle modification diet
post trauma/disaster/disease outbreak.
yy In coordinating for building convergence with Women’s Group, Self Help Groups (under
MoRD, GoI) for generating awareness, counselling to promote behaviour change - at
community level and relief camps.
Annexures | 65
yy In coordinating for building convergence with ICDS (AWW) and conduct growth monitoring
at AWC, counselling on nutrition, referral of cases (low weight babies, PW with nutritional
deficiency)
yy Attending VHSND during disaster - in relief camps for awareness generation on nutrition,
growth monitoring along with other service delivery.
yy In community level care for emergency & coordination for first aid stabilization and follow-
up visit to patient.
yy In organizing special “Day Clinics” to enhance attendance for ambulatory outpatient services.
yy Support ASHA to ensure home based care for new born and young children.
yy Assisting ASHA: Assist the ASHA/similar village health volunteer to motivate the TB patients
in taking regular treatment
5. Functions of Reporting and Record Maintenance:
yy Register entries and housekeeping work, data entry; report preparation and review meetings.
yy Support CHO in enabling every HWC to have a folder for every family.
yy Attending monthly meetings at PHC
yy Ensure timely documentation and registration of all births and deaths under the jurisdiction
of Sub Centre.
yy Attend VHSNC meetings and ensure that the minutes of the meetings are recorded and
maintained.
yy Making and timely submission of reports for various programs i.e. RCH Portal, NCD, HMIS,
IDSP, NIKSHAY etc.
Multi-Purpose Worker-Male (MPW-M) of HWC-SHC

1. Clinical Work
Under the supervision of CHO, the MPW-M performs the following functions:
yy General OPD services and managing cases at HWC-SHC that are referred by ASHAs /or visit the
health centre with any illness or problem.
yy Identification, referral and follow-up: Mobilize community members including children and
guide them to nearest screening camps, health facilities/Referral centre, for registration, early
identification of gestational diabetes and syphilis during pregnancy, STI/RTI, eye, ENT, TB, leprosy,
non-communicable diseases, vector borne diseases, common mental conditions, substance use
and Epilepsy cases, delays in development and disability and other congenital anomalies.
yy Referring of adolescents with anaemia, underweight, issues related to nutrition etc. to AB-HWCs.
Follow-up of sick and malnourished children regarding their nutrition intake, especially those
discharged from NRCs.
yy Counselling and Health Education to the community on:
a. Importance of institutional delivery, early and exclusive breastfeeding, seeking postnatal
care, weaning and complementary feeding, consuming nutritious diet and where to go for
delivery.
b. Importance of complementary feeding, its components, on consuming supplementary
nutrition at AWCs and consuming iron-rich diet in children to avoid anaemia.
c. Childhood and adolescent healthcare services including nutrition, personal hygiene,
sanitation, vaccination, healthy eating behaviour, in the community through home visits
and through VHSNDs.
d. Activities for prevention and early detection of hearing impairment/deafness, visual
impairments at the level of health facility, community and schools.
yy Motivate adolescents to attend VHSND sessions related to adolescent health.
yy Sensitization of community regarding entitlements provided by government under various
national programs
yy Information and prevention of RTIs, STIs, HIV/AIDS through health education in the community.
yy Aware the community and adolescents regarding the various government programmes for
adolescents’ health Nutrition such WIFS, school deworming programme etc.
yy Awareness Generation: Utilize meetings of the Village Health Nutrition and Sanitation
Committee/Mahila Arogya Samiti (VHSNC/MAS) to raise awareness about the needs of palliative
care patients, and mobilize individual and community level support, including accessing
assistance available through other Government programmes, assess symptoms
yy Facilitate opening of Bank Account, Aadhar card registration of patients and ensure entry in
portals such as Nikshay / TB notification register at health facility for DBT transfer.
yy Maintain a record of cases in his area, who are under treatment for tuberculosis and leprosy
yy Co-ordinate and participate in the outreach activities of PHC/CHC/ District Mobile dental clinic.
yy Attending monthly meetings at PHC
yy Supportive and Supervisory function to ASHA.
yy Support ASHA in active case detection of cases in the community and referral of suspected cases
with skin patches to MO.
yy Assist the ASHA/similar village health volunteer to motivate the TB patients in taking regular
treatment
yy In organizing special “Day Clinics” to enhance attendance for ambulatory outpatient services.
Annexures | 67
Annexure 6
List of Essential Medicines for HWC-SHC/UHWC
S. No. Medicine Name
Anesthetics Agent
1 Oxygen gas for inhalation
2 Lignocaine Topical form 5%
(Plain Lignocaine Injection can be kept at SC if enough case load is there)
Analgesics, antipyretics, non-steroidal anti-inflammatory medicines, medicines used to treat gout and
disease modifying agents used in rheumatoid disorders
3 Aspirin (Acetylsalicylic acid)
Tablet 75 mg
(Not to be used in suspected dengue patients and other clinical conditions without prescription)
4 Diclofenac Tablet 50 mg
Diclofenac Injection 25 mg/ml
5 Ibuprofen Tablet 200 mg
(Not to be used in suspected dengue patients and other clinical conditions without prescription)
6 Paracetamol tablet 250 mg, Paracetamol Syrup 125 mg/5 ml Paracetamol Syrup 250 mg/5 ml
Anti-allergic and medicines used in anaphylaxis
7 Levocetirizine 5 mg Tablet Levocetirizine Oral Liquid
8 Hydrocortisone Succinate Injection 100 mg
9 Pheniramine Injection 22.75 mg/ml
10 Adrenaline Injection 1mg/ml
(Should be part of all emergency drugs)
Anti-dotes and other substances used in poisoning
11 Atropine Injection 1 mg/ml
(Ampoules should be made available)
12 Activated Charcoal
Anti-convulsant/ Anti-epileptic/ Anti-psychotic
13 Magnesium Sulfate Injection (50% solution), 2 ml ampoule
14 Diazepam Tablet 5 mg Diazepam Tablet 10 mg Diazepam rectal suppository*
(Controlled medicine)
15 Midazolam Nasal Spray*
(For emergency purpose)
16 Phenobarbitone Tablet 30 mg Phenobarbitone Tablet 60 mg Phenobarbitone Oral liquid 20 mg/5 ml
17 Phenytoin Tablet 50 mg Phenytoin Tablet 300 mg
18 Sodium valproate Tablet 200 mg Sodium valproate Tablet 500 mg Sodium valproate Syrup each 5 ml
contains 200 mg
Intestinal Anthelmintics
19 Albendazole Tablet 400 mg Albendazole Oral liquid 200 mg/5 ml
Anti-filarial
20 Diethylcarbamazine Tablet 100 mg Diethylcarbamazine Oral liquid 120 mg/5 ml
Anti-bacterial
21 Amoxicillin Capsule 250 mg, Amoxicillin Capsule 500 mg Amoxicillin Oral liquid 250 mg/5 ml Amoxicillin
Dispersible Tablet 250 mg
22 Gentamicin Injection 10 mg/ml Gentamicin Injection 80 mg/m
23 Tab Co-trimoxazole [Sulphamethoxazol 80 mg +Trimethoprim 400 mg] Tab. 20 mg trimethoprim +
100 mg sulphamethoxazole Co-trimoxazole Oral Liquid [Sulphamethoxazole 200 mg + Trimethoprim
40 mg/5 ml]
24 Doxycycline Capsule 100 mg
25 Metronidazole Tablet 200 mg Metronidazole Tablet 400 mg
26 Norfloxacin tab/ oral Liquid
Anti-leprosy medicines
27 As per Program Guidelines (Adults and Pediatrics)
Anti-tuberculosis medicines
28 As per Program Guidelines (Adults and Pediatrics)
Anti-fungal medicines
29 Clotrimazole Ointment Clotrimazole Cream 1% Clotrimazole Vaginal Tablet Clotrimazole Drops 1%
Clotrimazole Oral Solution
30 Miconazole Ointment
31 Fluconazole 150 mg Tablet
Anti-malarial medicines
32 As Per Program Guidelines (Adults and Pediatrics)
Medicines used in Palliative care
33 Lactulose Oral liquid 10 g/15 ml
34 Povidone Iodine Lotion and Ointment
Anti-anaemic medicines
35 Ferrous salt 100 mg + Folic acid 500 mcg Tablet Ferrous salt 20 mg + Folic acid 100 mcg Table Ferrous
salt 60 mg + Folic acid 500 mcg Table Ferrous salt 45 mg + Folic acid 100 mcg Table Ferrous sulphate +
Folic acid Syrup
36 Folic acid Tablet 5 mg Folic acid Tablet 400 mcg
37 Vitamin K Injection 1 mg/ml
Cardiovascular medicines (Medicines used in angina)
38 Isosorbide-5- mononitrate Tablet 5 mg
39 Atenolol Tablet 50 mg
40 Metoprolol Tablet 25 mg Metoprolol SR Tablet 25 mg
41 Isosorbide dinitrate Tablet 5 mg (Sublingual)
Anti-hypertensive medicines
42 Amlodipine Tablet 2.5 mg Amlodipine Tablet 5 mg
43 Enalapril Tablet 5 mg
44 Telmisartan Tablet 40 mg
45 Hydrochlorothiazide Tablet 12.5 mg Hydrochlorothiazide Tablet 25 mg
Hypolipidemic medicines
46 Atorvastatin Tablet 10 mg
Medicines used in Dementia
47 Alprazolam Tablet 0.25 mg Alprazolam Tablet 0.5 mg
Annexures | 69
Dermatological medicines (Topical)
48 Silver sulphadiazine Cream 1%
49 Betamethasone Cream 0.05%
50 Calamine Lotion
51 Benzyl benzoate ointment/lotion
52 Mupirocin (anti -bacterial cream)
53 Potassium Permanganate 0.1%
54 Zinc Oxide Cream 10%
Disinfectants and antiseptics
55 Ethyl alcohol (Denatured) Solution 70%
56 Hydrogen peroxide Solution 6%
57 Methylrosanilinium chloride (Gentian Violet)
58 Bleaching powder Containing not less than 30% w/w of available chlorine (as per I.P)
59 Gama Benzene Hexachloride
60 Framycetin sulphate (Ointment)
Ear, nose and throat medicines
61 Ciprofloxacin Drops 0.3 % Ciprofloxacin Tablet 250 mg Ciprofloxacin Tablet 500 mg
62 Boro-Spirit ear drop
63 Ear wax solvent drops (combination of Benzocaine, Chlorbutol, Paradichlorobenzene and Turpentine
Oil)
Gastrointestinal medicines
64 Ranitidine Tablet 150 mg Ranitidine Injection
65 Omeprazole capsule 20 mg
66 Ondansetron Tablet 4 mg Ondansetron Oral liquid 2 mg/5 ml Ondansetron Injection 2 mg/ml
67 Ispaghula Granules/ Husk/ Powder (Herbal Medicine)
68 Oral rehydration salts (ORS)
69 Zinc sulphate Dispersible Tablet 20 mg Zinc Sulphate Syrup
70 Dicyclomine Tablet 10 mg Dicyclomine Injection
71 Dioctyl sulfosuccinate sodium
72 Magnesium Hydroxide liquid
73 Senna Powder (Herbal Medicine)
74 Domperidone Tablet Domperidone Syrup
Contraceptives
75 Ethinylestradiol (A) + Levonorgestrel Tablet 0.03 mg (A) + 0.15 mg (B)
76 Copper bearing intra-uterine device IUCD 380 A & IUCD 375
77 Male Condom
78 Ormeloxifene Tablet 30mg
79 Emergency contraceptive Pill Levonorgestrel 1.5 mg
80 Medroxyprogesterone Acetate Injection 150 mg
81 FP Commodities: PTK
Medicines used in Diabetes Mellitus
82 Glimepiride Tablet 2 mg
83 Metformin Tablet 500 mg Metformin SR Tablet 500 mg
84 Glibenclamide Tablet 2.5 mg/ Glibenclamide Tablet 5 mg
Thyroid and Anti-thyroid medicines
85 Levothyroxine Tablet 25 mcg Levothyroxine Tablet 50 mcg Levothyroxine Tablet 100 mcg
Vaccines
86 As per Current National Programme Guidelines
87 Rabies vaccine
Oxytocics & Abortificent Medicine
88 Misoprostol Tablet 200 mcg
(Should be use with caution)
Medicines acting on the respiratory tract
89 Budesonide Respirator solution for use in nebulizer 0.5 mg/ml
(Nebulizer Essential)
90 Salbutamol Tablet 2 mg Salbutamol Oral liquid 2 mg/5 ml Salbutamol Respirator solution for use in
nebulizer 5mg/ml
(Nebulizer Essential)
91 Normal Saline Drops
92 Dextromethorphan oral Syrup
93 Hyoscinebutylbromide Tablet 10 mg
Solutions correcting water, electrolyte disturbances and acid-base disturbances
94 Ringer lactate Injection
95 Sodium chloride injection 0.9%
96 Dextrose 5% Dextrose 25%
Vitamins and minerals
97 Ascorbic acid (Vitamin C) Tablet 100 mg
98 Calcium Carbonate Tablet 500 mg
99 Cholecalciferol Tablet 60000 IU
100 Pyridoxine Tablet 25 mg Pyridoxine Tablet 50 mg Pyridoxine Tablet 100 mg
101 Vitamin A Oral liquid 100000 IU/ml
102 B Complex Tablet
Ophthalmological Medicines
103 Sodium Cromoglycate 2% Eye drop
104 Methylcellulose eye drops
Diuretics
105 Furosemide Injection (Lasix) Furosemide Tablet 40 mg
*Schedule H1 (Separate H1 Register shall be maintained- Name of drug, patient, prescriber and dispensed quantity shall be recorded.
Annexures | 71
ANNEXURE 7
List of Diagnostic Tests & Equipment for Gap Analysis at HWC-SHC
and UHWC
S. No. Types of Tests Method/Equipment Required
1. Essential Essential
Hemoglobin, HCG, Urine test, Blood Sugar, Malaria Technique – Sahli’s Hemoglobinometer, Digital
test, HIV, Dengue, Cervical Cancer, Iodine, Water Hemoglobinometer, (Paper based Hb test), Rapid
testing for fecal contamination and chlorination, card test, Multiparameter urine strip (Dipstick),
HbsAg test for Hep B, Filariasis, Syphilis, Sputum for Glucometer (Strip based), VIA method, Testing Kit,
AFB, Sickle cell rapid test * Sample collection, Filaria Strip test
NESTROFT, Solubility Test NESTROFT, Solubility Test
Desirable** Desirable**
HaemChip HaemChip
2. Desirable Desirable
Matching, Peripheral blood film, Reticulocyte 3 Part Hematology analyzer, Manual with reading
count, Absolute eosinophil count, Bleeding time using ESR analyzer, Blood group kit (manual),
and clotting time, Sickling Test for screening of Microscopy, Manual with microscopy/Solubility
Sickle cell anemia, NESTROFT Test for screening test/Cover slip test, Rapid card tests for combined
of Thalassemia*, DCIP test for screening HbE P. Falciparum and P. vivax, Turbidometer/
hemoglobinopathy*, Screening test for G6PD Nephelometer, Manual Kit, Semi Automated
enzyme deficiency, Urine test for pH, specific gravity, Biochemistry analyzer, HbA1C Analyzer, Wet
leucocyte esterase, glucose, bilirubin, urobilinogen, mounting, gram staining
ketone, protein, nitrite, Urine for microalbumin,
Stool for ova and cyst, Stool for Occult Blood, RPR/
VDRL test for syphilis, Typhoid test (IgM), Glucose
Tolerance test (GTT), S. Bilirubin (T), S. Bilirubin
direct and indirect, Serum creatinine, Blood Urea,
SGPT, SGOT, S. Alkaline Phosphatase, S. Total
Protein, S. Albumin & AG ratio, S. Globulin, S. Total
Cholesterol, S. Triglycerides, S.VLDL, S.HDL, S. LDL,
S. Uric acid, Glycosylated haemoglobin (HbA1C),
Serum Calcium, Wet mount and Gram stain for
RTI/STD, Gram staining for clinical specimen,
Throat swab (Albert stain) for Diphtheria, Stool for
hanging drop for Vibrio Cholera, Visual Inspection
Acetic Acid (VIA), rK39 for Kala Azar, TB – Mantoux,
Troponin – I, Pap smear
* For endemic areas only, **These services to be linked with Hub for UHWCs
Note: The Desirable will be over and above the tests and Equipment mentioned as essential.
Annexure 8
List of Equipment and Consumables for HWC-SHC/UHWC
S. HWC-SHC UHWC
Equipment
No. E D E D
Emergency
1. Ambu Bag (Paediatric size) with E E
Baby mask, Suction Machine,
Oxygen Administration
Equipment, I/V Stand, Tongue
Depressor, Oxygen Cylinder
with trolley, Mouth Gag,
Nebulizer
OPD
2. Digital Sphygmomanometer, E E
Sphygmomanometer Aneroid
300 mm, with cuff IS: 7652,
Kelly’s haemostat Forceps
straight 140 mm, Vulsellum
Uterine Forceps curved 25.5
cm, Cusco’s/Graves Speculum
vaginal bi-valve small, medium
and large, Sims retractor/
depressor, Sims Speculum
vaginal double ended ISS
Medium, Uterine Sound
Graduated, Flashlight/Torch
Box-type pre-focused (4 cell),
Weighing Scale, Adult 125
kg/280 lb, Weighing Scale,
Infant (10 Kg), Weighing
Scale, (baby) hanging type,
5 kg, Clinical Thermometer
oral & rectal, Stethoscope,
Foetoscope, Measuring Tape,
BP Apparatus (Digital), Mouth
Mirror, Snellen vision chart,
Near vision chart, Stadiometer,
Tuning fork.
Minor Treatment
3. Basin 825 ml. SS (Stainless E E
Steel), Basin deep (capacity 6
liters), Tray instrument/Dressing
with cover 310 x 195x63mm,
Torch (ordinary), Dressing Drum
with cover 0.945 liters stainless
steel, Sterilizer, Surgical Scissors
straight, 140 mm, Sponge
holder, Plain Forceps, Toothed
Forceps, Needle Holder, Suture
needle straight -10, Suture
needle curved, Kidney tray,
Artery Forceps, straight, 160
mm Stainless steel, Dressing
Forceps (spring type), 160 mm,
stainless steel, Cord cutting
Scissors, Blunt, curved on flat,
160 mm,
Annexures | 73
S. HWC-SHC UHWC
Equipment
No. E D E D
Examination Lamp, Gauze
Cutting Scissors Straight, Foam
Mattress.
Immunization Services
4. Vaccine Carrier, Ice pack box, E E
Tracking Bag and Tickler Box
(Immunization)
*ANM Room
5. Syringe (10 cc, 5 cc, 2 cc) and E E
AD Syringes (0.5 ml and 0.1 ml)
for immunization, Disposable
gloves, Mucus extractor ,
Disposable delivery Kit, Dry
cell/Battery, Disposable lancet
(Pricking needles), Disposable
Sterile Swabs, Routine
Immunization Monitoring
Chart, Blank Immunization
Cards/Joint MCH Card (one per
pregnant mother) and Tally
Sheets (one per immunization
session), IV canula and
Intravenous set, Chlorine
tablets, Sanitary napkins, Salt –
Iodine test kit, Kits for testing
residual chlorine in drinking
water, Mackintosh Sheets – 5
meters, Wooden spatula, Suture
Material, Online UPS 1 KVA with
60 minute backup.
*Only for HWC-SHC.
Miscellaneous
6. Fire Extinguisher, Buckets E E
Big (Plastic), Buckets Small
(Plastic), Dust bins- Blue, Dust
Bins – Red, Dust Bins – Yellow,
Dust Bins- Black, Black Disposal
bags, Red Disposal Bags, Yellow
Disposal Bags, Blue Translucent
Container, Sharps Container,
Hand Towels, Bed Sheet for
Examination Tables, Cleaning
material, detergent, Insecticide
treated nets.
Furniture /Non-Consumables
7. Chairs for patient waiting E E
area, Footstep, Office Chair,
Office Table, Screen Separators
with stand, Steel Almirah /
Cupboard/storage chests, Stool
for attendants.
Note: The above is the essential & basic list of Equipment, instruments and accessories etc. depending upon the type and case load the
state can add on. The Equipment, consumables and furniture mentioned under desirable are over and above the services mentioned as
essential.
ANNEXURE 9
Cleaning Protocols at HWC-SHC/UHWC
Routine cleaning is of utmost importance in every area of a health care facility. Certain chemicals are
recommended for cleaning, particularly in moderate and high-risk areas, but such chemicals keep on
changing based on scientific updates. It needs to be understood that since none of the chemicals used on
walls and floors provide 100% safety from various microorganisms and spores. So, behavior of staff towards
routine cleaning and adherence to infection prevention protocols is the most important action which needs
to be followed by health care staff and workforce.
Cleaning Frequency of Level of cleaning/ Method of Evaluation/

frequency, level cleaning disinfection (As cleaning/ auditing frequency
of cleaning/ per Spaulding’s Disinfection
disinfection Classification)
and evaluation/
auditing frequency
according to the
type of functional
area risk category
Functional Area
Risk Category
High risk areas Floors, walls and Cleaning and Routine Cleaning Weekly or monthly
Surfaces: Intermediate level with soap detergent if cleanliness of
yy Labour Room
Complex disinfection plus disinfection with high standards
Routine cleaning
aldehyde free high- is maintained as
yy Dressing room/ once in two hours
level disinfectant certified by Officer
Injection Room/ with aldehyde
(HLD) like 70% I/C Sanitation and
Emergency free high-level
isopropyl alcohol Infection Control
disinfectant (HLD)
yy Minor OT Team
like 70% isopropyl Spot Cleaning:
yy Laboratory alcohol
As required after
Spot Cleaning: disinfection with
0.5% chlorine
As required
solution.
OT table, Labour
All Equipment
beds and other
and instruments
such surfaces to
to be disinfected
be cleaned and
and cleaned with
disinfected after
aldehyde free high-
every use.
level disinfectant
Intensive deep like peracetic acid
cleaning: Weekly/ and autoclaving
Holidays accept heat sensitive
Equipment &
instruments.
Annexures | 75
Cleaning Frequency of Level of cleaning/ Method of Evaluation/
frequency, level cleaning disinfection (As cleaning/ auditing frequency
of cleaning/ per Spaulding’s Disinfection
disinfection Classification)
and evaluation/
auditing frequency
according to the
type of functional
area risk category
Functional Area
Risk Category
Moderate risk areas Floors, walls and Cleaning and low- Routine Cleaning Once in a month or
Surfaces: level disinfection with soap and once in two months
yy Consultation
Room detergent plus if cleanliness of
Routine cleaning
disinfection with high standards
yy Health & once in four hours
aldehyde free high- is maintained as
Wellness Room with aldehyde
level disinfectant certified by Officer
free high-level
yy Counselling (HLD) like 70% I/C Sanitation and
disinfectant (HLD)
Room isopropyl alcohol Infection Control
like 70% isopropyl
Team
yy Inpatient ward/ alcohol Spot Cleaning:
Day-Care room Spot Cleaning: As As required after
yy Toilets required disinfection with
0.5% chlorine
solution.
Intensive deep All Equipment
cleaning: Weekly/ and instruments
Holidays to be disinfected
and cleaned with
aldehyde free high-
level disinfectant
like peracetic acid
and autoclaving
accept heat sensitive
Equipment &
instruments.
Low risk areas Floors, walls and Cleaning with water Routine physical Once in three
Surfaces: and detergent removal of soil, dust months
yy Corridors
or foreign material
yy Waiting halls / Routine cleaning
followed by cleaning
Waiting Rooms/ for areas working with water and
Registration Area round the clock at Soap/ Quaternary
least once in a shift
yy Stores (Medicine or in areas having Ammonium
Store, Linen Compound.
general shift at
Store) least twice in the Spot Cleaning:
yy Pharmacy shift with water and As required after
Soap/ Quaternary disinfection with
Ammonium 0.5% chlorine
Compound solution
Spot Cleaning: As
required
Intensive deep
cleaning: Weekly/
Holidays
Note: For infective spills like blood, it should be first treated with 0.5% hypochlorite solution.
General Cleaning Practices for All Healthcare Settings
Before Cleaning
yy Check for additional (isolation) precautions signs
yy Follow precautions as indicated
yy Remove clutter before cleaning
yy Follow the manufacturer’s instructions for proper dilution and contact time for cleaning and
disinfecting solutions
yy Gather materials required for cleaning before entering the room
yy Visibly check and ensure all cleaning equipment itself is clean
yy Clean hands before entering the room
yy Prepare chemical dilutions and put on gloves before beginning cleaning.
During Cleaning
yy Progress from the least soiled areas to the most soiled areas and from high surfaces to low surfaces
yy Remove gross soil (visible to naked eye) prior to cleaning and disinfection
yy Minimize turbulence to prevent the dispersion of dust that may contain micro-organisms
yy Never shake mops
yy Use dust control mop prior to wet/damp mop. Do not use brooms
yy Wash the mop under running water before doing wet mopping
yy Do not ‘double-dip’ mops (dip the mop only once in the cleaning solution, as dipping it multiple
times may re contaminate it)
yy An area of 120 square feet to be mopped before re-dipping the mop in the solution
yy Cleaning solution to be changed after cleaning an area of 240 square feet (This does not apply to
critical areas like OT and ICU)
yy Change more frequently in heavily contaminated areas, when visibly soiled and immediately after
cleaning blood and body fluid spills
yy Be alert for needles and other sharp objects. Safely handle and dispose sharps into puncture proof
container
yy Report incident to supervisor
yy Collect waste, handle plastic bags from the top (do not compress bags with hands)
yy Clean hands on leaving the room
After Cleaning
yy Do not overstock rooms
yy Tools used for cleaning and disinfecting should be cleaned and dried between uses
yy Launder mop heads daily, keep the mop upright after use with cleaning surface upwards
yy All washed mop heads should be dried thoroughly before re-use
yy Clean sanitation cart and carts used to transport biomedical waste daily.
Annexures | 77
Annexure 10
Service Area Wise Protocol
Service Area (Please Mark): (OPD/ Side Lab/ Labour Room / Day Care IPD Area/ Any other etc.)
Room No:
Timings:
Staff in the room:
Designation Name
MO
CHO
Nurses
Other Health Care Staff
Sanitation staff
Security Guard
Activities (Key services provided):

1.
2.
3.
List of equipment and its maintenance:
Equipment’s/ Frequency of Cleaning material Responsible

S. No. Quantity
Material Utilization & frequency person
Toll Free number of BMMP:
Nodal person at the facility with contact details:
Records and Registers:
S. No. Name of the Key Frequency Person Responsible Designation of

Register Information of Updating Authority Responsible
Recorded for Verification of
in The Register
Register
Performance Indicators (Number/type of services/ number pf patients served/ numbers of procedures
undertaken/number of data recorded/medicines dispensed/Diagnostics conducted etc or any key services
being provided in the service area to be indicated below and their performance chart comparing current
and previous month/ year may also be displayed):
1.
2.
Performance
Periodicity: Cumulative from 1st quarter (April 2nd quarter (July 3rd quarter 4th quarter
April to March to June) to September) (October to (January to

December March)
Indicators

Previous Current Previous Current Previous Current Previous Current Previous Current
Year Year Year Year Year Year Year Year Year Year
Performance Bar Graph:
Cleaning Protocols:
Category of Service Area High Risk Moderate Risk Low Risk Remarks
(Please tick)
Availability of Colour coded Bins Not Available Partially Available Available
Adherence to IPC protocols Poor Needs Good/ Satisfactory
Improvement
Segregation of BMW Not Practiced Partially Practiced Fully adhered
Frequency of BMW disposal
(please indicate in hours)
Frequency of Cleaning (please
indicate in hours)
Date and time of last Cleaning
Date & time of supervision
Name & Signature of Supervisor
Annexures | 79
Annexure 11
Checklist for Daily Rounds
Observe/Monitor and
S. No. 1 2 3 4 5 6 7 8 9 10
Guide Date
1. Display of duty roster
and presence of staff
accordingly in their
respective duty station
2. Staff is in proper uniform &
maintains decorum
3. Department/Service
Area wise protocols and
performance displayed in
respective service areas.
4. Clinical practices as per the
SoPs in each service area
5. Privacy during patients’
examination is maintained
in all service areas
6. Quality of performance by
Nursing and other junior
staff
7. Infection control protocols
are adhered
8. BMW is segregated
properly
9. Adherence to handing
over-taking over protocols
in all areas.
10. Availability of stock
required in every service
area (Drugs & Consumables
etc.)
11. Necessary Equipment are
available and functional in
every service area
12. Sterilization of the
instruments is as per
protocols in
12.2 Labour Room
12.3 casualty
12.4 Any other service
areas.
13. Only sterilized/autoclaved
instruments are used in
service areas
14. Records of sterilization are
maintained
Observe/Monitor and
S. No. 1 2 3 4 5 6 7 8 9 10
Guide Date
15. Cleanliness and check
the cleaning checklist for
completion in the below
mentioned areas (OPD,
Wards, Labor room, OT,
Lab. & diagnostic rooms,
Injection & dressing room,
Toilets etc.) as per cleaning
protocols.
16. Presence of junk or
unnecessary item in service
areas
Round taken by (Please tick and sign):

1. MO/CHO/Health Facility In charge:
2. Staff Nurse
3. Any Other:
Annexures | 81
ANNEXURE 12: LIST OF CONTRIBUTORS
(Indian Public Health Standards)
A. COMMITTEE MEMBERS
1. Main Committee (As per order No. F.NO. P/17029/02/2-17-NHM-IV, Dated 21st May
2018)
1. Dr. Manohar Agnani, Joint Secretary- Policy- Chairman
2. Dr. Anil Kumar, Addl. DDG, DGHS-Co- Co-chair
3. Prof. Jayanta K. Das, Director, NIHFW
4. Dr. Rajani Ved, ED, NHSRC
5. Dr. Rajesh Kumar, Prof & Head of Public Health, PGIMER, Chandigarh
6. Dr. Pankaj Arora, Asst. Prof Dept. of Hospital Administration, PGIMER, Chandigarh
7. Dr. Yogesh Jain, JSS
8. Dr. Suresh Mohammad, World Bank
9. Dr. B. S Arora, Ex DGFW, Advisor NHM, UP
10. Special Secretary, DHS, Orissa
11. Director Public Health- Tamil Nadu
12. Dr. Satish Pawar (Additional Mission Director)- Maharashtra
13. CMO- Rajasthan (State to nominate)
14. CMO- Uttar Pradesh (State to nominate)
15. Dr. J. N. Srivastava, Advisor, Quality Division NHSRC
16. Dr. S. B Sinha Advisor NHSRC
17. Ms. Mona Gupta- Advisor NHSRC
18. Dr. Mayank Sharma, Consultant NHM
19. Dr. Himanshu Bhushan, Advisor, PHA division, NHSRC- Member Secretary
2. Sub-Committee - Physical Infrastructure (As per order No. F.NO. P/17029/02/2-17-

NHM-IV, Dated 21st May 2018)
1. Dr. Anil Kumar, Addl. DDG, DGHS, MoHFW
2. Dr. Rajesh Kumar, Prof & Head of Public Health PGIMER, Chandigarh
3. Dr. Srikumar Venkataraman- Assistant Professor of Physical Medicine & Rehabilitation, AIIMS Delhi
4. Dr. J. N. Srivastava, Advisor, Quality Division NHSRC
5. Mr. Anurag Salwan, Head (ID) & VP (O), HITES
6. Mr. Rajiv Kanaujia, Sr. Architect Head of CDN, MoHFW
7. Mr. Mukesh Bajpai, Sr. Architect, CDB, MoHFW
8. Dr. Himanshu Bhushan, Advisor, PHA division, NHSRC- Member Secretary
9. Mr. Rajneesh Upmanyu Sr. Consultant Infrastructure MoHFW
10. Dr. Krushna Sirmanwar, Consultant NHM, MoHFW
3. Sub- Committee – Human Resource for Health (As per order No. F.NO. P/17029/02/2-
17-NHM-IV, Dated 21st May 2018)
1. Dr. Mohd. Shaukat, Advisor NCD
2. Dr. Nobhojit Roy, Advisor PHP, NHSRC
3. WHO representative
4. Nodal person HRM- MP
5. Ms. Sumitha Chalil, Sr. Consultant NHM
6. Dr. Rakshita Khanijou, Consultant NHM
7. Ms. Mona Gupta, Advisor policy and planning- NHSRC-Member Secretary
4. Sub Committee - Urban Health facilities (As per order No. F.NO. P/17029/02/2-17-
NHM-IV, Dated 21st May 2018)
1. Dr. Basab Gupta, DC NUHM- Chair
2. Dr. Ranjana Garg, AC NUHM
3. Dr. Chandrakant Lahariya, WHO representative
4. MD-NHM West Bengal or representative
5. Municipal Corporations Mumbai- representative
6. Municipal Corporations Chennai- representative
7. Dr. Adil Shafie, Sr. Consultant NUHM
8. Dr. Himanshu Bhushan, Advisor PHA- Member Secretary.
5. Sub Committee - Equipment list (As per order No. F.NO. P/17029/02/2-17-NHM-IV,
Dated 21st May 2018)
1. Dr. Sandhya Kabra- Additional Director NCDC- Chair
2. HLL- representative
3. Kerala Medical Service Corporation-rep
4. Odisha Medical Service Corporation-rep
5. Mr. Mandar Randive, Consultant, NHM
6. Dr. S.B. Sinha, Advisor NHSRC-Member Secretary
6. Sub Committee - Essential drug List (As per order No. F.NO. P/17029/02/2-17-NHM-
IV, Dated 21st May 2018)
1. Dr. V.S. Salhotra, Add. DDG (RNTCP)- Chair
2. DCGI- Representative
3. Dr. C. D Tripathi, Director Professor, Department of Pharmacology, Vardhman Mahavir Medical
College, New Delhi
4. Dr. Anil Gurtoo, Director Professor, Department of Medicine, Lady Hardinge Medical College, New Delhi
5. Nodal Person- Rajasthan Medical service Corporation
6. Nodal Person- Madhya Pradesh Medical service Corporation
7. Nodal Person- Tamil Nadu Medical Service Corporation
8. Nominee Kerala Medical Service Corporation
9. Dr. Rakshita Khanijou, NHM Consultant
10. Dr. J.N Srivastava- Advisor NHSRC- Member Secretary
Annexures | 83
B. MINISTRY OF HEALTH AND FAMILY WELFARE
S No Name Designation
1. Mr. Rajesh Bhushan Secretary
2. Prof. (Dr.) Sunil Kumar Director General of Health Services
3. Ms. Preeti Sudan Former Secretary
4. Mr. Vikas Sheel Additional Secretary & Mission Director, NHM
5. Mr. Manoj Jhalani Former Additional Secretary & Mission Director,
NHM
6. Ms. Vandana Gurnani Former Additional Secretary & Mission Director,
NHM
7. Mr. Vishal Chauhan Joint Secretary, Policy
8. Dr. Harmeet Singh Joint Secretary, Urban Health
9. Ms. Preeti Pant Former Joint Secretary, Urban Health
10. Dr. Sachin Mittal Director – NHM
11. Dr. Neha Garg Director – NHM
12. Dr. Harsh Mangla Director – NHM
13. Dr. N. Yuvaraj Former Director – NHM
C. NITI Ayog
1. Dr. K Madan Gopal Senior Consultant (Health)
D. OTHER INVITED MEMBERS

1. MOHFW Representatives
1. Dr. C. Das DADG (NCD), DGHS
2. Dr. Manas P. Roy DADG, DGHS
3. Dr. Rathi Balachandran ADG
4. Dr. Gowri N Sengupta ADG, DGHS
5. Dr. L. Swasticharan Addl. DDG
6. Dr. Raghuram Rao DD (TB)
7. Dr. Neeraj Dhingra Add. Dir, NVBDCP
8. Dr. Arun K Bansal Add. Dir, NVBDCP
9. Dr. Sandhya Kabra Add. Dir, NVHCP, NCDC
10. Dr. Indu Grewal CMO (NFSG), DGHS
11. Dr. Sushil Vimal DC (NUHM)
12. Dr. Sumita Ghosh AC In Charge(Child Health, RBSK, AH,CAC & AD)
13. Dr. Sila Deb AC ( CH & I/C - Nutrition)
14. Dr. Jyoti Rawat AC (NUHM)
15. Dr. Dinesh Baswal Former DC (MH) IC
16. Dr. Sandhya Bhullar Former Dir, NHM-2
17. Mr. S. Nayak Dy. Secretary
18. Mr. VK Bhalla US (NHM)
19. Ms. Chandni Chandran Asstt Sec
20. Mr. Sanjeev Gupta FC, NHM
21. Dr. Renu Srivastava Advisor, MNCH
22. Dr. Bhumika Talwar Lead Consultant
23. Dr. Vinita Srivastava National senior consultant, Blood cell, NHM
24. Dr. Kumkum Marwah Sr. Consultant (Nutrition), DGHS
25. Dr Pranav Bhushan Senior Technical Officer, ADU
26. Mr. Vikas Sheemar Sr. Consultant
27. Mr. Mohd. Kamil Sr. Consultant
28. Dr. Shikha Bansal Sr. Consultant
29. Dr. Nisha Kadyan Sr. Consultant, NUHM
30. Er. Dinesh Kumar Sr. Consultant
31. Dr. Richa Saxena Sr. Consultant
32. Dr. Narendra Goswami Sr. Consultant
33. Dr. Sarita Sinha Sr. Consultant, HMIS
34. Dr. Shraddha Masih Sr. Consultant, NHM
35. Dr. Abhiskek Gupta Sr. Consultant, NUHM
36. Dr. Vishal Kataria National Technical Consultant, CH
37. Dr. Kapil Joshi Sr Consultant CH
38. Dr. Disha Agarwal Senior Consultant, Immunization
39. Dr. Sudipta Basa Sr. Consultant
40. Dr. Pankaj Agarwal Consultant, Immunization
41. Dr. Akriti Mehta Consultant NOHP
42. Dr. Gaurav Chauhan Consultant, PHPP
43. Dr. Ashish Bhat Consultant, NHM
44. Dr. Sneha Mutreja Consultant, NHM
45. Dr. Deepak Kumar Consultant Adolescent Health
46. Dr. Pooja Gupta Consultant
47. Dr. Prayas Joshi Consultant, NUHM
48. Ms. Seema Pati Consultant, NUHM
49. Dr. Apurva Kohli Jr. Consultant
50. Mr. Maisnam Niresh Tech- Consultant
51. Dr. Asif Shafie Tech- Consultant
52. Dr. Nadeem Shaikh Intern
53. Dr. Prashant Intern
54. Mr. Shahid Ali Warsi Intern, NHM
55. Mr. Suresh Kumar Singh SSO
2. State Representatives
S No Name Designation State
1. Dr. Bishnu Prasad Mahapatra Add. Dir (HRH) Odisha
2. Dr. PK Srinivas Advisor, NUHM, NHM Karnataka
3. Dr. Archana Mishra DD, MH, NHM Madhya Pradesh
4. Dr. Mangala Gomare Dy EHO-FWMCH/ NUHM Mumbai, Maharashtra
5. Dr. Sanjeev Tak CMHO, Medical & Health Dept Udaipur, Rajasthan
6. Dr. V.B. Singh CMO, Medical & Health Dept Varanasi, UP
Annexures | 85
S No Name Designation State
7. Mr. Mrunal Das HMD, NHM Odisha
8. Dr. KL Sahu Retd. DHS Bhopal, MP
9. Dr. Bhavana Sharma Prof, Head, Ophthalmology, Bhopal
AIIMS
10. Dr. RK Singh Specialist, Cardiologist Bhopal
11. Dr. Kamlesh Deopujari Specialist MS (Ortho) Bhopal
12. Dr. Mrs. Priti Chaturvedi Anaesthetist Bhopal
13. Dr. Mrs. Nirmala Dubey Sr. dental Surgeon Bhopal
14. Dr. B.D Pawar Sr. IPHS Consultant, NHM PHD, Maharashtra
15. Dr. K. Kolanda Swamy DPH & PM Chennai
16. Dr. V. Prakash Health Officer, Dir of PH Chennai
17. Dr. B. Viduthalai Virumbi Medical Officer, DPH&PM, SPMU Chennai
18. Dr. Rakesh Shrivastava Medical Specialist Bhopal
19. Mr. Sanjay Nema Consultant civil, NHM MP
20. Dr. John Add. Prof Surgery Bhopal
21. Dr. Sharma Asso. prof. Bhopal
22. Dr. Mahesh Maheshwaran Asso. Prof. Paediatrics Bhopal
23. Dr. Surendra K. Shrivastava Associate Prof. Surgery GMC, Bhopal
24. Dr. Kamlesh Jain Associate Professor cum SNO, Chhattisgarh
DHS
25. Dr. Gauvav Khandelwal Asst. Prof. Cardiology Bhopal
26. Dr. Nitin Pandya Asst. prof. Derma Bhopal
27. Dr. Rajesh Asst. Prof. Medicine Bhopal
28. Dr. Mahendra Attani Asst. Prof. Nephrology Bhopal
29. Dr. Saurabh Jain Asst. Prof. Urology Bhopal
30. Mr. Urya Nag SPM Chhattisgarh
31. Dr. Sonia SPM, NHM Punjab
32. Mr. Adait kumar Pradhan SPM, NHM Odisha
33. Dr. Sudha Gupta SPM, NHM UP
34. Mr. Sukanta Kumar Mishra Program Manager, NHM Odisha
35. Ms. K. Priya SUHM, NHM Tamilnadu
36. Mr. Navdeep Gautam SNO- NUHM, NHM Punjab
37. Mr. V Ramaswamy Executive engineer Tamil Nadu service corporation
38. Mr. K Anandan Senior manager Tamil Nadu service corporation
39. Dr. M Sharmila General manager Tamil Nadu service corporation
40. Dr. D S Nagesh Scientist G SCTIMST Trivandrum
41. Mr. A L Biran Chandra SM HITES HITES, Noida
42. Dr. Dileep Kumar General Manager Kerela Medical Service
Corporation
43. Mr. Prakash Mallick Biomedical Enginner NHM Odisha
44. Dr. Ritesh Tanwar DD, Ayushman Bharat DGHS, MP
45. Dr. Himani Yadav DD, Child health, RBSK, Nutrition DGHS, MP
3. Institutional Experts
S No Name Designation Organisation
1. Mr. Bijender Singh EA Health
2. Dr. Jyoti DD IDSP, NCDC
3. Dr. B.S. Garg Director & Prof. of Community MGIMS, Sewagram
Medicine
4. Dr Aakash Srivastava Addl. Director &HOD, NPCCHH NCDC
5. Dr Rameshwar Sorokhaibam Deputy Director, NPCCHH NCDC
6. Dr. Anu George APD SHARE India
7. Dr. Vinay Garg DD NCDC
8. Mr. J Chaudhary AMD, WB H&FW, Govt Of WB
9. Mr. Prem Prakash DGM HITES, Noida
10. Dr. Anubhav Srivastav Asstt. Director NCDC
11. Dr. Manish Chaturvedi Professor NIHFW
12. Dr. Rajesh Kumar Prof. & HOD, SPH PGIMER, Chandigarh
13. Dr. C M Singh Professor AIIMS Patna
14. Dr. Rajesh Khadgawat Professor, Department of AIIMS, Delhi
Endocrinology & Metabolism
15. Dr. Ashish Pathas Prof. Paediatric RD Gardi Med. College, Ujjain
16. Dr. Deepika Garg Professor, ENT & HNS MGIMS Sewagram, Maharashtra
17. Dr. Rajib Das Gupta Professor JNU, New delhi
18. Dr. Mayank Dwivedi Public Health Specialist & Lab CDC
advisor
19. Dr. Suraj Singh Associate Prof. AIIMS, New Delhi
20. Dr. Bhawna Gulati Associate Professor ASCI, HYD
21. Dr. Tej Prakash Singh Associate Professor, Dept of AIIMS, Delhi
Emergency Medicine JPNATC
22. Dr. Ravikirti Associate Prof. AIIMS, Patna
23. Dr. Rekha Singh Associate Prof AIIMS, Bhopal
24. Dr. Vikas Gupta Associate Prof. AIIMS, Bhopal
25. Dr. Abhir singh Associate Prof. AIIMS, Bhopal
26. Dr. NP Singh Asst. Prof. Surgery AIIMS, Bhopal
27. Dr. R R Bonde Associate Prof. EpMC
28. Dr. Dhiraj Bhandari Associate Prof & Intensivist MGIMS, Maharashtra
29. Dr. Arun Singh HOD, Dept. of Neonatology AIIMS, Jodhpur
30. Dr. Priyanka Bhushan Prof & Head, Public health ITS Dental College
Dentistry
31. Lt Col (Dr.) Kundan Kumar Dental officer Base Hospital, Army Dental
Corps
32. Dr. R K Singh HOD, Emergency Medicine SGPGI, Lucknow
Department
33. Dr. Kirti Iyengar NPO (RH) UNFPA
34. Dr. Dilip Singh Mairembam NPO WHO India
35. Dr. Madhur Gupta Technical officer, Pharmaceutical WHO , New Delhi
36. Er. Dhirendra Chaudhary Superintendent Engineer CPWD, GOI
37. Mr. Rohit FC NHM-Finance
Annexures | 87
S No Name Designation Organisation
38. Dr. Vandana Kumar Consultant WHO India
39. Dr. Sushant Agarwal Consultant QI ADB, NHSRC
4. NHSRC
S. No. Name Designation
1. Maj Gen (Prof ) Atul Kotwal Executive Director
2. Dr. M. A Balasubramanya Advisor, CP-CPHC
3. Dr. Ranjan K Choudhury Advisor, HCT
4. Ms. Sweta Roy Lead Consultant, HRH & HPIP
5. Dr. Neha Dumka Lead Consultant, KMD
6. Dr. Deepika Sharma Lead Consultant, QPS
7. Mr. Sandeep Sharma Lead Consultant, HCF
8. Mr. Prasanth KS Senior Consultant, PHA
9. Dr. Smita Shrivastava Senior Consultant, PHA
10. Dr. Aashima Bhatnagar Senior Consultant, PHA
11. Mr Divya Prakash Senior Consultant, HRH
12. Ms. Vertika Agarwal Senior Consultant, HCT
13. Mr. Anjaney Shahi Senior Consultant, HCT
14. Mr. Padam Khanna Senior Consultant, KMD
15. Dr. Suman Senior Consultant, CP-CPHC
16. Dr. Vinay Bothra Former Sr. Consultant, PHA
17. Mr. Ajit Kumar Singh Former Sr. Consultant, PHA
18. Mr. Mohd. Ameel Former Sr. Consultant, HCT
19. Dr. Parminder Gautam Former Sr. Consultant, QPS
20. Dr. Neha Jain Former Sr. Consultant, PHA
21. Dr. Rupendra Sahota Former Sr. Consultant, CP-CPHC
22. Dr. Kalpana Pawalia Consultant, PHA
23. Dr. Poonam Consultant, PHA
24. Dr. Ashutosh Kothari Consultant, PHA
25. Ms. Neelam Tirkey Consultant, PHA
26. Dr. Aditi Joshi Consultant, PHA
27. Dr. Nidhi Awasthi Consultant, PHA
28. Ms. Diksha Consultant, PHA
29. Ms. Isha Sharma Consultant, HRH
30. Ms. Charu Consultant, HCT
31. Ms. Manisha Sharma Consultant, HCT
32. Dr. Arpita Agrawal Consultant, QPS
33. Mr. Gulam Rafey Consultant, QPS
34. Dr. Anwar Mirza Consultant, CP-CPHC
35. Ms. Vasudha Khanna Legal Consultant, PHA
36. Mr. Mohd. Shoeb Alam Architect, New Delhi
37. Mr. Sangramsinh Gaikwad Architect, Maharashtra
38. Dr. Shuchi Soni Former Consultant, PHA
39. Ms. Shivangi Rai Former Legal Consultant, PHA
40. Dr. Gurinder Randhawa Former Consultant, QPS
41. Dr. Shifa Arora Former Consultant, PHA
42. Mr. PS Vigneshwaran Former Consultant, HCT
43. Dr. Yogita Kumar Former Consultant, HCT
44. Mr. Ajai Basil Former Consultant, HCT
45. Dr. Archana Pandey Former Consultant, PHA
46. Dr. Rashmi Wadhwa Former Consultant, QPS
47. Ms. Ritu Junior Consultant, HCT
48. Mr. Hariom Tiwari Short term Consultant, QPS
49. Ms. Vasundhra Bharti Former External Consultant, PHA
50. Ms. Nasrain Nikhat Khan Former External Consultant, QPS
51. Dr. Bhupinder Singh Former External Consultant, PHA
52. Ms. Akshita Singh Former External Consultant, PHA
53. Dr. Sujeet Sinha Former Short-term Consultant, QPS
54. Ms. Shilpa Pawar Former Short-term Consultant, QPS
55. Ms. Ashu Ranga Fellow, PHA
56. Dr. Musarrat Siddiqui Fellow, PHA
57. Dr. Syeda Tahseen Kulsum Fellow, PHA
58. Dr. Isha Chalotra Former Fellow PHA
59. Dr. Ishita Former Fellow PHA
60. Mr. Pawan Former Fellow HCT
61. Ms. Purnima Former Fellow HCT
62. Dr. Kushagr Duggal Former Fellow, PHA
63. Dr. Diksha Dhupar Former Fellow, PHA
64. Dr. Deepak Bhagat Former Fellow, PHA
65. Dr. Charu Chandrika Fellow, PHA
66. Dr. Priya Goel Fellow, PHA
67. Dr. Zeba Bano Fellow, PHA
5. RRCNE
1. Dr. Ashok Roy Director, RRCNE
2. Dr. Joydeep Das Lead Consultant, RRCNE
3. Dr. Pankaj Thomas Sr. Consultant, RRCNE
4. Dr. Surajit Choud’hury Consultant, RRCNE
5. Dr. Sidharth Maurya Consultant, RRCNE
6. Ms. Sagarika Kalita Consultant, RRCNE
6. Administrative and Secretarial Support

1. Brig. Sanjay Baweja Principal Administrative Officer
2. Ms. Garima Verma Consultant, Publications
3. Ms. Megha Mathur Consultant, Publications
4. Ms. Manju Bisht Secretarial Assistant
5. Mr. Ravi Kumar Office Assistant
6. Mr. Prakash Chemjung Office Assistant
Annexures | 89
Notes
Notes
Notes
Ministry of Health and Family Welfare
Government of India

Indian Public Health Standards

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INDIAN PUBLIC HEALTH

List of Abbreviations xix

Table of Contents | xvii

AEFI Adverse Events Following Immunization

List of Abbreviations | xix

List of Abbreviations | xxi

c. Standard protocol to be adopted for better service delivery;

f. Essential diagnostics to be provided in the health facilities;

i. Ensuring accountability and governance in service delivery; and

j. Framework of implementation of IPHS.

Also, recently the Astana Declaration in October 2018 endorsed

The IPHS 2022 guidelines have been framed for-

Population norm for HWC-SHC/UHWC

S. No. Type of PHC facility Plain (population) Hilly/Tribal(population)

1 HWC-SHC 5000 3000

2 UHWC 15,000- 20,000 -

Criteria for IPHS Compliance | 11

Service flow at UHWC

Details of the services to be provided by HWCs are mentioned at Annexure 2.

The Urban HWCs should be located preferably within 1 kilometer

14 | INDIAN PUBLIC HEALTH STANDARDS | HEALTH AND WELLNESS CentreS- HWC-SHC/UHWCS

8.1.1. General Appearance and Upkeep

8.1.1.1. Maintenance and upkeep

8.1.1.4. Garden and green areas

8.1.1.5. Environment friendly features

8.1.1.6. Disabled and elderly friendly access

8.1.1.7. Disaster and emergency preparedness

8.1.1.8. Fire safety

8.1.1.9. Electric supply

8.1.1.11. Water Supply

8.1.1.12. Drainage and Sanitation

8.1.1.13. Waste management

8.1.1.14. Infection Prevention & Control

8.1.1.15. Infrastructure for Clinical Services

1. Screening and Holding Area

Patient amenities in waiting areas should include:

5. Health and Wellness Area

8. Day care beds

10. Teleconsultation area

11. Support Services

12. Oxygen Supply

Table: Oxygen delivery systems in HWC-SHC/UHWC

B Type (1500 Lts

Important Note regarding Oxygen delivery systems

S. No. Human Resource required Required Numbers

S. No. Human Resource Required Numbers

*Sanitation and security services** can be hired/outsourced

Table: Minimum Performance Standards (HR)

8.2.1. Capacity Building

8.2.2. Conduct and Behavioural Standards

8.2.3. Safety Measures for HRH

Updated list of Medicines as per EML is available at https://nhsrcindia.org/sites/default/files/202107/

Biomedical Equipment Management & Maintenance Program (BMMP) is an initiative by Ministry of

8.6. Quality assurance

Figure: Measurement system under NQAS

Figure: Institutional Framework under NQAS

National Level Central Quality Supervisory Committee

State Level State QA Committee State QA Unit

District Level District QA Committee District QA Unit

Facility Level Facility QA team

Summary of the activities is given in Figure.

Patient Safety and Infection Control

8.7. Implementation of IPHS

Institutional structures operational for community-based monitoring such as social accountability,

List of Abbreviations xix

2. Sub-Committee - Physical Infrastructure (As per order No. F.NO. P/17029/02/2-17-